Prenatal and Neonatal Detection of Isomeric Situs and the Association with Maternal Comorbidities

Abstract

Our purpose was to investigate the relationship between fetal and neonatal isomeric situs and maternal comorbidities. We identified all prenatally and postnatally diagnosed fetuses with left or right isomerism between March 2011 and October 2020 in Southern Nevada. We determined isomerism by the relationship of the abdominal inferior vena cava and descending aorta. For each case, we evaluated the presence of maternal comorbidities. We did not include routine obstetric ultrasound findings in determining the presence of maternal comorbidities. For each fetus or infant, we determined the presence of congenital heart disease. We did not analyze any other organ systems. We identified 48 cases. Of the 48, 31 (65%) occurred in mothers with comorbidities. Of the 48, 40 were live-born. Of the 40 live-born, 26 (65%) occurred with maternal comorbidities (p = 0.0001 for both the total and live-borns associated with maternal comorbidities). Of the 40 live-born, 1 had no prenatal care. Of the 39 with prenatal care, 38 (97%) were prenatally diagnosed. Of the 48 total cases: 23 had no congenital heart disease other than a patent foramen ovale, and 25 had critical congenital heart disease. Of the 23 without congenital heart disease, 19 (83%) were associated with maternal comorbidities, and of the 25 with critical congenital heart disease, 12 (48%) were associated with maternal comorbidities (p = 0.041). Prenatal detection of isomerism approached 100%. Most of those with isomerism occurred in association with maternal comorbidities. Most of those with critical congenital heart disease occurred in mothers without comorbidities.

Keywords

Isomerism - Maternal comorbidities - Prenatal diagnosis

Publication History

Received: 20 July 2021

Accepted: 07 November 2021

Article published online:
05 May 2023