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Situs Ambiguous (Heterotaxy)

Kehrer JDK - MedPix (2009)

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: Situs Ambiguous (Heterotaxy)

History: 29-year-old caucasion female, G2P0 s/p in-vitro fertilization procedure approximately 20 weeks earlier without complication. Noted diamnionic dichorionic twins on previous ultrasound. Referred for repeat US for date confirmation, placental location and evaluation of anatomy. No current complaints. Patient received regular pre-natal care.

Findings: 1) Situs Ambiguous, Heterotaxy Cardiosplenic Syndrome, Baby B, Female, with levocardia (heart pointing towards the left) and the stomach bubble on the right. Four-chamber view revealed no cardiac anomalies with adequate visualization right ventricular outflow tract. Due to high risk of congenital heart disease and visceral anomalies fetal echocardiogram ordered. 2) Dichorionic Diamniotic twin gestation with dates matching fetal size and symmetric growth 3) No distinct gross anomalies noted with Baby A

Ddx: 1. Situs Inversus - Levocardia vs. Dextrocardia 2. Situs Ambiguous (Heterotaxy) - Left Isomerism (Polysplenic) - Right Isomerism (Asplenia) 3. Malrotation of the gut 4. Imaging Artifact

Dxhow: Ultrasound Examination

Exam: Vitals: Afebrile, HR 80, RR 16, O2 Sat 99%, BP 120/74 PE: Within normal limits Cardiac: Normal S1/S2, no murmurs, rubs or gallops Ext: No evidence of LE/generalized edema

No MeSH data available.


Transverse image of the placenta in a twin pregnancy at 20 weeks gestational age.  Demonstrates a triangular peak of placental villi extending into the potential space formed from the reflection of apposed amniotic and chorionic layers from each fetus: the twin peak sign.  Confirmed to be dizygotic with evidence of both a male and female Fetus.
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MPX1757_synpic48828: Transverse image of the placenta in a twin pregnancy at 20 weeks gestational age. Demonstrates a triangular peak of placental villi extending into the potential space formed from the reflection of apposed amniotic and chorionic layers from each fetus: the twin peak sign. Confirmed to be dizygotic with evidence of both a male and female Fetus.


Situs Ambiguous (Heterotaxy)

Kehrer JDK - MedPix (2009)

Transverse image of the placenta in a twin pregnancy at 20 weeks gestational age.  Demonstrates a triangular peak of placental villi extending into the potential space formed from the reflection of apposed amniotic and chorionic layers from each fetus: the twin peak sign.  Confirmed to be dizygotic with evidence of both a male and female Fetus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1757&req=5

MPX1757_synpic48828: Transverse image of the placenta in a twin pregnancy at 20 weeks gestational age. Demonstrates a triangular peak of placental villi extending into the potential space formed from the reflection of apposed amniotic and chorionic layers from each fetus: the twin peak sign. Confirmed to be dizygotic with evidence of both a male and female Fetus.

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: Situs Ambiguous (Heterotaxy)

History: 29-year-old caucasion female, G2P0 s/p in-vitro fertilization procedure approximately 20 weeks earlier without complication. Noted diamnionic dichorionic twins on previous ultrasound. Referred for repeat US for date confirmation, placental location and evaluation of anatomy. No current complaints. Patient received regular pre-natal care.

Findings: 1) Situs Ambiguous, Heterotaxy Cardiosplenic Syndrome, Baby B, Female, with levocardia (heart pointing towards the left) and the stomach bubble on the right. Four-chamber view revealed no cardiac anomalies with adequate visualization right ventricular outflow tract. Due to high risk of congenital heart disease and visceral anomalies fetal echocardiogram ordered. 2) Dichorionic Diamniotic twin gestation with dates matching fetal size and symmetric growth 3) No distinct gross anomalies noted with Baby A

Ddx: 1. Situs Inversus - Levocardia vs. Dextrocardia 2. Situs Ambiguous (Heterotaxy) - Left Isomerism (Polysplenic) - Right Isomerism (Asplenia) 3. Malrotation of the gut 4. Imaging Artifact

Dxhow: Ultrasound Examination

Exam: Vitals: Afebrile, HR 80, RR 16, O2 Sat 99%, BP 120/74 PE: Within normal limits Cardiac: Normal S1/S2, no murmurs, rubs or gallops Ext: No evidence of LE/generalized edema

No MeSH data available.