Prenatal ultrasound diagnosis and clinical follow-up analysis of fetal isolated double aortic arch

Abstract

Objective To investigate the value of clinical follow-up in prenatal diagnosis of isolated double aortic arch (DAA). Methods The clinical follow-up materials were retrospectively reviewed in 17 fetuses. Of all the isolated DAA fetuses, the accuracy rate of prenatal diagnosis was confirmed by CT, MRI, autopsy or echocardiography, and pregnant outcomes were summarized. Results A total of 17 fetuses had a sonographic diagnosis of isolated DAA in our centers at a mean gestational age of 23-32(27±3)weeks, with mother mean age 19-44 (28±6) years old. One case of DAA type-A was misdiagnosed, 15 cases were delivered with 2 cases occurred respiratory distress or mild dysphagia, who received surgical treatment, and 13 cases clinical findings were unremarkable at the fellow-up of 24 months, the silent-rate of clinical symptoms was 86%. Termination of pregnancy happened in 2 cases, with 1 (6%) had additional ventricular septal defects, another (6%) had additional anomalies of congenital high airway obstruction syndrome. In 17 cases of fetuses with isolated DAA, there were 15(88%) cases with dominant right-sided arch, 1 case (6%) with dominant left arch, and 1 case (6%) with equal arches in size. Karyotyping prenatal testing was offered to 15 parents with normal results. Conclusions Prenatal ultrasound can accurately diagnose isolated DAA by multiple sections scan, expanding diagnostic ideas by combination with other medical imaging data to prevent apparent life-threatening event, or to guide for ex-utero intrapartum treatment. Isolated DAA clinical follow-up results in good outcome. Key words: Ultrasonography, prenatal; Aortic arch syndromes; Vascular ring