Ectopia cordis: prenatal diagnosis, perinatal outcomes, and postnatal follow-up of an international multicenter cohort case series

• Published in: The journal of maternal-fetal & neonatal medicine 2023-12, Vol.36 (1), p.2203791-2203791
• Main Authors: Araujo Júnior, Edward, Coutinho, Luiza Graça, Bravo-Valenzuela, Nathalie Jeanne, Aquino, Patrícia, Rocha, Luciane Alves da, Rizzo, Giuseppe, Tonni, Gabriele, Respondek-Liberska, Maria, Slodki, Maciej, Wolter, Aline, Axt-Fliedner, Roland
• Format: Article
• Language: English
• Subjects: Adolescent; chest wall deformity; congenital heart disease; Ectopia cordis; Ectopia Cordis - diagnostic imaging; Female; Follow-Up Studies; Heart Defects, Congenital - diagnosis; Heart Septal Defects, Ventricular; Humans; Infant; omphalocele; pentalogy of Cantrell; Pregnancy; Prenatal Diagnosis; Retrospective Studies; Ultrasonography, Prenatal
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2023.2203791

This study aimed to analyze prenatal diagnosis, perinatal outcomes, and postnatal follow-up in fetuses with ectopia cordis (EC). This retrospective analysis accessed 31 patients with EC who were either diagnosed or referred to a tertiary Fetal Medicine centers for EC diagnosis in Brazil, Germany, Italy, and Poland. We analyzed prenatal diagnosis, perinatal outcomes, and follow-up in these patients. Our study included a cohort of 31 fetuses with EC, 4 and 27 of whom had partial and complete protrusion of the heart through a ventral defect in the thoracoabdominal wall, respectively. EC was diagnosed by fetal echocardiography at a mean gestational age of 20.3 ± 8.6 weeks (range, 8-35 weeks). Of the four cases, in which the karyotype was performed, all of them had a normal result (1 - 46,XX and 3 - 46,XY). Five patients showed conotruncal abnormalities and six ventricular septal defects. Termination of pregnancy (TOP) was performed in 15 cases (48%) and seven pregnant women had spontaneous fetal demise (22.5%). Of the seven fetuses that were born alive, four of them died, and three infants underwent surgery. Among these three infants, all of them survived, one was 5 months, 13 years old and 29 years old at the time of study completion. Ectopia cordis is associated with high mortality rates and intracardiac/extra-cardiac defects. Ventricular septal defects and conotruncal anomalies were the more common intracardiac defects associated with EC. However, in this cohort of fetuses with EC the incidence of PC was lower than reported in the literature.