Ebstein anomaly

Fabrice Cuillier, MD*; M. S. Avignon, MD**

*    Department of Gynecology; Felix Guyon’ Hospital, 97400 Saint-Denis, Reunion Island, France;
**   Gynecologist, 97450 Saint Denis, Reunion Island, France.

Case report

A 25-year-old woman (G1P0) was referred to our antenatal unit at 26 weeks. Her family history focused on congenital disease was negative and she didn"t take any potentially harmful or teratogenic drugs.
Our sonographic examination showed a right atrial enlargement (Images 1, 2) with apical displacement of the incompetent tricuspid leaflet (Images 1, 2, 3, 4). The pulmonary artery seemed hypoplastic.
The parents opted for the continuation of the pregnancy. Amniocentesis revealed normal karyotype and absence of Di-George syndrome. The neonate was delivered at 35 weeks and the diagnosis of Ebstein anomaly was confirmed.

Images 1, 2: The images show transverse scans of the fetal thorax at the level of the four-chamber view. The apical displacement of the septal leaflet and enlargement of the right ventricle can be seen.

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Images 3, 4: The images show color Doppler transverse scans of the fetal thorax at the level of the four-chamber view. The apical displacement of the septal leaflet and enlargement of the right ventricle can be seen. Note also the left-axis deviation of the interventricular septum.

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Images 5, 6: The images show a comparison between the diameter of the aorta and the pulmonary artery which appears hypoplastic.

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Images 7, 8: The images show a comparison between the diameter of the aortic and ductal arches. Image 8 - the pulmonary artery appears slightly narrower (6.1 mm) in comparison with the ascending aorta (7.1 mm).

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Videos 1, 2: The videos show transverse scans of the fetal thorax at the level of the four-chamber view. The apical displacement of the septal leaflet and enlargement of the right ventricle can be seen.

Videos 3, 4: The images show color Doppler transverse scans of the fetal thorax at the level of the four-chamber view.

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