Dextrocardia in pregnancy: 20 years' experience

To identify all pregnancies complicated by maternal dextrocardia and report the obstetric performance in these patients.

A retrospective review of all deliveries between May 1984 and December 2004 at Prince of Wales Hospital, Chinese University of Hong Kong. Maternal demographic data as well as information on the antenatal course and delivery outcome were abstracted from the maternal records. Neonatal record review yielded information on the gestational age at delivery, birth weight, Apgar scores, sex and neonatal conditions after delivery.

Fifteen singleton pregnancies in 9 patients with dextrocardia were identified. There were 6 pregnancies in 3 patients with situs inversus and 9 pregnancies in 6 patients with isolated dextrocardia. There were no apparent antenatal complications. None of the patients developed any cardiac symptoms antenatally. All the infants had a 5-minute Apgar score > 7. Four small-for-gestational-age (SGA) infants, defined after correcting for parity, gestational age, maternal height and maternal entry weight, occurred in patients with situs inversus. This is significantly different from the 10% expected (p < 0.002). No SGA infants were born to patients with isolated dextrocardia.

Pregnancies complicated by maternal isolated dextrocardia did not have any detrimental effect on the disease or vice versa. However, SGA infants should be watched in patients with situs inversus.