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2012-08-07-10 Right aortic arch, isolated cleft lip ©Jayprakash Shah

Right aortic arch, isolated cleft lip 

Jayprakash Shah, MD; FICOG1; Parth Shah MD.,D.G.O.; FIGE 2; Meeta Patel  MBBS; D.G.O.2
1 Rajni Fetal Medicine center, Ahmedabad, India
2 Rajni Hospital for Women, Ahmedabad, India

Case report:

21-year-old patient, primigravida, non consanguineous marriage, had first scan at 20 weeks 5 days by her last mentrual period. These are following findings:
Figure 1: Abdominal circumference view in breech presentation fetus

Figure 2: 4 chamber view. Note descending aorta in center of spine instead of little left.

Figure 3: Left ventricular outflow tract on the left & right ventricular outflow tract on the right. Notice the increased distance between main pulmonary atery and ascending aorta

Figure 4: 3-vessel view. Notice the increased distance between  main pulmonary atery and ascending aorta . Notice circular ring around trachea

Figure 5: 2D / Color – Ring around trachea

Figure 6:
 Right lateral isolated cleft lip in 3D not involving nose. Note the intact gum visible inside cleft

Figure 7:
 Intact palate with tongue

Figure 8: Post delivery images  showing  right partial cleft uper lip. Notice intact palate.

Video 1:4D showing right partial cleft lip not involving nostrils. No cleft palate. 2D clip showing right isolated cleft lip

Video 2 – Color flow at 3-vessel view showing ring connection with trachea in center

Right aortic arch with isolated small right cleft lip was diagnosed and confirmed after birth.
No karyotype was offered. Repeated scans at 30 weeks & 36 weeks confirmed above findings. No worsening of condition. No hydrops.
Patient was induced for labor with prostaglandin gel with cervical score 6/10. Male baby weighing 2500gr was delivered on the same day. No resuscitation required. No active neonatal care required. On day 2, echocardiography confirmed the diagnosis. The baby is doing well after birth.


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