open access

Vol 91, No 8 (2020)
Research paper
Published online: 2020-08-31
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The associtation between aberrant right subclavian artery and trisomy 21 in a tertiary center in Turkey

Mete Sucu1, Mehmet Özsürmeli1, Erol Arslan1, Cansun Demir1, Cüneyt Evrüke1
·
Pubmed: 32902843
·
Ginekol Pol 2020;91(8):460-464.
Affiliations
  1. Cukuova University Medical Faculty, Obstetrics and Gynaecology Department, Perinatology Unit., Mithat ozsan Bulvari, 01130 Adana, Türkiye

open access

Vol 91, No 8 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-08-31

Abstract

Objectives: We hoped to reveal the frequency of Aberrant Right Subclavian Artery (ARSA) and to find the relationship of isolated/non-isolated ARSA with chromosomal defects and other fetal congenital heart diseases (FCHD) in a heterogeneous population.

Material and methods: This was a retrospective cohort study conducted between December 2015 to September 2018. Women admitted for routine ultrasound examination or referred to our hospital for a suspected fetal anomaly were underwent detailed fetal anomaly ultrasonography scan and tested for the presence of ARSA.

Results: ARSA was detected in 27 patients and an isolated finding in 13 (48%) cases. Among 13 cases with isolated ARSA, trisomy 21 was diagnosed in 1 case. In the non-isolated group (n: 14, 52%), five cases presented with trisomy 21. There was no significant difference of trisomy 21 frequency between isolated and non-isolated groups (7.6% vs 35.7%, p = 0.08). In 3 patients, FCHD was diagnosed and 2 of them had trisomy 21.

Conclusions: Our study shows that ARSA can be the only marker in trisomy 21. The examination of the subclavian artery must be a part of the fetal anomaly ultrasonography. Detecting an ARSA should increase the attentiveness of the sonographer to investigate for the other markers of trisomy 21. In the existence of other findings, invasive diagnostic procedures should be offered to the patients, whereas in cases that arsa is the only finding, other risk factors should be investigated to offer karyotyping or cell-free DNA analysis.

Abstract

Objectives: We hoped to reveal the frequency of Aberrant Right Subclavian Artery (ARSA) and to find the relationship of isolated/non-isolated ARSA with chromosomal defects and other fetal congenital heart diseases (FCHD) in a heterogeneous population.

Material and methods: This was a retrospective cohort study conducted between December 2015 to September 2018. Women admitted for routine ultrasound examination or referred to our hospital for a suspected fetal anomaly were underwent detailed fetal anomaly ultrasonography scan and tested for the presence of ARSA.

Results: ARSA was detected in 27 patients and an isolated finding in 13 (48%) cases. Among 13 cases with isolated ARSA, trisomy 21 was diagnosed in 1 case. In the non-isolated group (n: 14, 52%), five cases presented with trisomy 21. There was no significant difference of trisomy 21 frequency between isolated and non-isolated groups (7.6% vs 35.7%, p = 0.08). In 3 patients, FCHD was diagnosed and 2 of them had trisomy 21.

Conclusions: Our study shows that ARSA can be the only marker in trisomy 21. The examination of the subclavian artery must be a part of the fetal anomaly ultrasonography. Detecting an ARSA should increase the attentiveness of the sonographer to investigate for the other markers of trisomy 21. In the existence of other findings, invasive diagnostic procedures should be offered to the patients, whereas in cases that arsa is the only finding, other risk factors should be investigated to offer karyotyping or cell-free DNA analysis.

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Keywords

ARSA; trisomy 21; isolated; karyotyping; ultrasound

About this article
Title

The associtation between aberrant right subclavian artery and trisomy 21 in a tertiary center in Turkey

Journal

Ginekologia Polska

Issue

Vol 91, No 8 (2020)

Article type

Research paper

Pages

460-464

Published online

2020-08-31

Page views

1420

Article views/downloads

1580

DOI

10.5603/GP.2020.0078

Pubmed

32902843

Bibliographic record

Ginekol Pol 2020;91(8):460-464.

Keywords

ARSA
trisomy 21
isolated
karyotyping
ultrasound

Authors

Mete Sucu
Mehmet Özsürmeli
Erol Arslan
Cansun Demir
Cüneyt Evrüke

References (16)
  1. Zapata H, Edwards JE, Titus JL. Aberrant right subclavian artery with left aortic arch: associated cardiac anomalies. Pediatr Cardiol. 1993; 14(3): 159–161.
  2. Chaoui R, Heling KS, Sarioglu N, et al. Aberrant right subclavian artery as a new cardiac sign in second- and third-trimester fetuses with Down syndrome. Am J Obstet Gynecol. 2005; 192(1): 257–263.
  3. Chaoui R, Rake A, Heling KS. Aortic arch with four vessels: aberrant right subclavian artery. Ultrasound Obstet Gynecol. 2008; 31(1): 115–117.
  4. Carrizo GJ, Marjani MA. Dysphagia lusoria caused by an aberrant right subclavian artery. Tex Heart Inst J. 2004; 31(2): 168–171.
  5. Hara M, Satake M, Itoh M, et al. Radiographic findings of aberrant right subclavian artery initially depicted on CT. Radiat Med. 2003; 21(4): 161–165.
  6. - Fe, Sevket O, Akin H, et al. Aberrant right subclavian artery in Down syndrome fetuses. Prenat Diagn. 2013; 33(3): 209–13.
  7. Paladini D, Sglavo G, Pastore G, et al. Aberrant right subclavian artery: incidence and correlation with other markers of Down syndrome in second-trimester fetuses. Ultrasound Obstet Gynecol. 2012; 39(2): 191–195.
  8. Rembouskos G, Passamonti U, De Robertis V, et al. Aberrant right subclavian artery (ARSA) in unselected population at first and second trimester ultrasonography. Prenat Diagn. 2012; 32(10): 968–975.
  9. Agathokleous M, Chaveeva P, Poon LCY, et al. Meta-analysis of second-trimester markers for trisomy 21. Ultrasound Obstet Gynecol. 2013; 41(3): 247–261.
  10. Scala C, Leone Roberti Maggiore U, Candiani M, et al. Aberrant right subclavian artery in fetuses with Down syndrome: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015; 46(3): 266–276.
  11. De León-Luis J, Gámez F, Bravo C, et al. Second-trimester fetal aberrant right subclavian artery: original study, systematic review and meta-analysis of performance in detection of Down syndrome. Ultrasound Obstet Gynecol. 2014; 44(2): 147–153.
  12. Borenstein M, Minekawa R, Zidere V, et al. Aberrant right subclavian artery at 16 to 23 + 6 weeks of gestation: a marker for chromosomal abnormality. Ultrasound Obstet Gynecol. 2010; 36(5): 548–552.
  13. Gul A, Corbacioglu A, Bakirci IT, et al. Associated anomalies and outcome of fetal aberrant right subclavian artery. Arch Gynecol Obstet. 2012; 285(1): 27–30.
  14. Esmer AC, Gul A, Nehir A, et al. Detection rate of trisomy 21 in fetuses with isolated and non-isolated aberrant right subclavian artery. Fetal Diagn Ther. 2013; 34(3): 140–145.
  15. Willruth AM, Dwinger N, Ritgen J, et al. Fetal aberrant right subclavian artery (ARSA) - a potential new soft marker in the genetic scan? Ultraschall Med. 2012; 33(7): E114–E118.
  16. Zalel Y, Achiron R, Yagel S, et al. Fetal aberrant right subclavian artery in normal and Down syndrome fetuses. Ultrasound Obstet Gynecol. 2008; 31(1): 25–29.

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