Ultrasound diagnosis of ectopia cordis in the third trimester of pregnancy. Case report

Abstract

Introduction: ectopia cordis is a rare, life-threatening, non-syndromic congenital cardiac malformation characterized by complete or partial location of the heart outside the thoracic cavity, frequently associated with diaphragmatic, pericardial, or thoracic and abdominal wall defects or both.

Objective: to present a case of thoracoabdominal ectopia cordis diagnosed at 30 weeks of gestation by ultrasound.

Case presentation: 24-year-old female patient, mixed-race skin color, with obstetric history of two pregnancies, two births, without abortions. She went to the emergency room of the “Augostinho Neto” Provincial Hospital, Kuanza Norte Province, Angola's Popular Republic, for physical assault. An abdominal ultrasound was performed and a single, cephalic fetus, 30 weeks of gestation, female, with good vitality, moderate polyhydramnios, grade II anterior placenta and total displacement of the heart outside the thoracic cavity, with a thoracoabdominal location, was confirmed. He presented intracardiac malformations, bilateral cleft lip, discrete ascites, and more marked bilateral pleural effusion on the right side. A color and three-dimensional Doppler ultrasound was carried out, confirming the findings described above.

Conclusions: ectopia cordis is a complex, rare congenital anomaly that, with the use of ultrasound, can be diagnosed from the first trimester of pregnancy. This presentation emphasizes the importance of adequate prenatal diagnosis of congenital anomalies, which allows important decisions to be made in the neonatal period.