Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch

ObjectiveThe aim was to summarise the prenatal ultrasound characteristics, associated anomalies and pregnancy outcomes of fetal right aortic arch (RAA) and to discuss the value of prenatal ultrasound diagnosis and prognostic analysis.MethodsWe retrospectively analysed 157 cases of fetal RAA diagnose...

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Main Authors: Yuting Xie, Zongjie Weng, Ronghua Wang, Qiumei Wu, Wen Ling, Jinwen Chen, Shan Guo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1521338/full
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author Yuting Xie
Zongjie Weng
Ronghua Wang
Qiumei Wu
Wen Ling
Jinwen Chen
Shan Guo
author_facet Yuting Xie
Zongjie Weng
Ronghua Wang
Qiumei Wu
Wen Ling
Jinwen Chen
Shan Guo
author_sort Yuting Xie
collection DOAJ
description ObjectiveThe aim was to summarise the prenatal ultrasound characteristics, associated anomalies and pregnancy outcomes of fetal right aortic arch (RAA) and to discuss the value of prenatal ultrasound diagnosis and prognostic analysis.MethodsWe retrospectively analysed 157 cases of fetal RAA diagnosed via prenatal ultrasound in our hospital from October 2017 to October 2022. RAA features were characterised by comparing prenatal ultrasound data with anatomical casting results after pregnancy termination or postnatal imaging and surgical intervention to analyse the prognosis and misdiagnoses of fetal RAA.ResultsOf the 157 fetal RAA cases, 50 (31.8%) cases were isolated RAA and 107 (68.2%) cases were nonisolated RAA. In terms of typing, 78 cases (49.7%) of right aortic arch-aberrant left subclavian artery (RAA-ALSA) and 75 cases (47.8%) of right aortic arch-mirror branch (RAA-MB), 3 cases (1.9%) of right aortic arch-isolated left subclavian artery (RAA-ILSA) and 1 case (0.6%) of right aortic arch-isolated left innominate artery (RAA-ILINA) were identified, and the incidence of combined cardiac anomalies and chromosomal anomalies was significantly greater in the RAA-MB group than the RAA-ALSA group. The live birth rate was significantly lower in the nonisolated RAA group than the isolated RAA group, and the prognosis of RAA-MB was significantly worse than that of RAA-ALSA. Among the 76 surviving patients, 72 (94.7%) cases were correctly diagnosed via prenatal ultrasound, and 4 (5.3%) cases had missed diagnoses and misdiagnoses. Of the 81 terminated pregnancies, 19 cases received pathological anatomy or vascular casting, including 18 cases with results consistent with the prenatal ultrasound and 1 case with inconsistent results.ConclusionsPrenatal echocardiography is useful for diagnosing fetal RAA. It is also necessary to classify RAA types as accurately as possible and detect the presence of potential cardiac and extracardiac anomalies and genetic abnormalities, which facilitates prenatal counselling and prognostic assessment of fetuses with RAA.
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spelling doaj-art-98f550d8d0944d858bc68c7736a1dd4a2025-01-29T06:45:36ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011210.3389/fcvm.2025.15213381521338Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic archYuting Xie0Zongjie Weng1Ronghua Wang2Qiumei Wu3Wen Ling4Jinwen Chen5Shan Guo6Department of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaDepartment of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaDepartment of Medical Ultrasonics, Second Hospital of Sanming City, Sanming, ChinaDepartment of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaDepartment of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaDepartment of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaDepartment of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaObjectiveThe aim was to summarise the prenatal ultrasound characteristics, associated anomalies and pregnancy outcomes of fetal right aortic arch (RAA) and to discuss the value of prenatal ultrasound diagnosis and prognostic analysis.MethodsWe retrospectively analysed 157 cases of fetal RAA diagnosed via prenatal ultrasound in our hospital from October 2017 to October 2022. RAA features were characterised by comparing prenatal ultrasound data with anatomical casting results after pregnancy termination or postnatal imaging and surgical intervention to analyse the prognosis and misdiagnoses of fetal RAA.ResultsOf the 157 fetal RAA cases, 50 (31.8%) cases were isolated RAA and 107 (68.2%) cases were nonisolated RAA. In terms of typing, 78 cases (49.7%) of right aortic arch-aberrant left subclavian artery (RAA-ALSA) and 75 cases (47.8%) of right aortic arch-mirror branch (RAA-MB), 3 cases (1.9%) of right aortic arch-isolated left subclavian artery (RAA-ILSA) and 1 case (0.6%) of right aortic arch-isolated left innominate artery (RAA-ILINA) were identified, and the incidence of combined cardiac anomalies and chromosomal anomalies was significantly greater in the RAA-MB group than the RAA-ALSA group. The live birth rate was significantly lower in the nonisolated RAA group than the isolated RAA group, and the prognosis of RAA-MB was significantly worse than that of RAA-ALSA. Among the 76 surviving patients, 72 (94.7%) cases were correctly diagnosed via prenatal ultrasound, and 4 (5.3%) cases had missed diagnoses and misdiagnoses. Of the 81 terminated pregnancies, 19 cases received pathological anatomy or vascular casting, including 18 cases with results consistent with the prenatal ultrasound and 1 case with inconsistent results.ConclusionsPrenatal echocardiography is useful for diagnosing fetal RAA. It is also necessary to classify RAA types as accurately as possible and detect the presence of potential cardiac and extracardiac anomalies and genetic abnormalities, which facilitates prenatal counselling and prognostic assessment of fetuses with RAA.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1521338/fullfetusechocardiographyright aortic archprenatal diagnosispregnancy outcome
spellingShingle Yuting Xie
Zongjie Weng
Ronghua Wang
Qiumei Wu
Wen Ling
Jinwen Chen
Shan Guo
Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch
Frontiers in Cardiovascular Medicine
fetus
echocardiography
right aortic arch
prenatal diagnosis
pregnancy outcome
title Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch
title_full Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch
title_fullStr Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch
title_full_unstemmed Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch
title_short Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch
title_sort prenatal ultrasound diagnosis associated anomalies and pregnancy outcomes of fetal right aortic arch
topic fetus
echocardiography
right aortic arch
prenatal diagnosis
pregnancy outcome
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1521338/full
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AT ronghuawang prenatalultrasounddiagnosisassociatedanomaliesandpregnancyoutcomesoffetalrightaorticarch
AT qiumeiwu prenatalultrasounddiagnosisassociatedanomaliesandpregnancyoutcomesoffetalrightaorticarch
AT wenling prenatalultrasounddiagnosisassociatedanomaliesandpregnancyoutcomesoffetalrightaorticarch
AT jinwenchen prenatalultrasounddiagnosisassociatedanomaliesandpregnancyoutcomesoffetalrightaorticarch
AT shanguo prenatalultrasounddiagnosisassociatedanomaliesandpregnancyoutcomesoffetalrightaorticarch