2012-01-05-09 Ebstein anomaly ©Fabrice Cuillier www.thefetus.net
Fabrice Cuillier, MD; D. Mardemootoo, Midwife.
Department of Gynecology, Félix Guyon’ Hospital, 97400 Saint-Denis, Ile de la Réunion, France.
This 25-year-old woman (G3P2) was referred to our antenatal unit at 24 weeks for a cardiopathy with suspicion of Tetralogy of Fallot. There was no known family history of congenital disease. The patient did not take any chemotherapy such as Lithium, but she is alcohol and marijuana abuser.
Her first sonographic examination was performed at 24 weeks and revealed right atrial enlargement with apical displacement of the tricuspid valve leaflets (Images 1, 2, 3, 4) and regurgitation (Images 5, 6).
Images 1, 2, 3, 4: Right atrial enlargement with apical tricuspid leaflet displacement.
Images 5, 6: Color Doppler images of the heart at the level of the four-chamber view showing tricuspid regurgitation.
Images 7, 8: 26 weeks; echocardiography showed the same anomalies; the aorta was of normal size with normal flow.
Images 9, 10, 11, 12: The pulmonary artery seemed hypoplastic - probably functional hypoplasia.
After taking extensive counsel, the patient decided to continue the pregnancy. An amniocentesis was normal without Di-George syndrome.
The neonate was born at 26 weeks and the diagnosis of Ebstein’s anomaly was confirmed. The newborn has died a few days later.