Transversal cardiac diameter is increased in fetuses with dextro-transposition of the great arteries older than 28th weeks of gestation.

Abstract

Objectives: In majority of congenital heart defects the size of the fetal heart is normal (without cardiomegaly). Aim of this study was to establish normal ranges of fetal transversal cardiac diameter (4CV TW ED) and to compare fetal dextro-transposition of the great arteries (d-TGA) with normal ranges for 4CV TW ED.

Methods: Retrospectively of 3,553 records we analyzed and included 1,154 healthy singleton fetuses as a control group. Consecutive percentiles for 4CV TW ED diameter according to the gestational age (GA) were calculated. 74 fetuses with d-TGA were analyzed in 3rd trimester.

Results: The -2, -1, +1 and +2 Z-scores of 4CV TW ED between weeks 18 and 37 of gestation were calculated. In the group of fetuses with d-TGA 68 % of them had 4CV TW ED > +2 Z-score fitted for GA. Rashkind procedure during first 24 h after birth was performed in 63 % cases. Increased 4CV TW ED was more frequently seen in fetuses who needed Rashkind procedure after birth, but without statistical significance.

Conclusions: 4CV TW ED measurement during the third trimester scans as a cardiac screening tool in obstetrical practice may potentially help to detect d-TGA and indicate further echocardiographic examination in case of d-TGA suspicion. 4CV TW ED was not helpful to predict the necessity for neonatal Rashkind procedure.