Case Report

Prenatal Diagnosis of Cardiac Diverticulum with Pericardial Effusion in the First Trimester of Pregnancy with Resolution after Early Pericardiocentesis

Table 2

Description of the cases of cardiac diverticulum reported in the literature.

AuthorGA di SizeSexLocationKaryotypeAssociated anomaliesInterventionPrenatal progressionNeonatalFollow-up

1Kitchiner et al. (1990) [13]33FemaleApex VICardiomegalyNoStableVaginal delivery 40 w; cardiomegaly, tachypnea, heart murmur, muscular IVC, and mild mitral regurgitationAsymptomatic at 3.5 months of life

2Hornberger et al. (1994) [9]31Lateral wall below tricuspid valve (RV)NoStableVaginal delivery at termAsymptomatic at 12 months of life

3Carles et al. (1995) [24]13MaleApex LVPericardial effusionTOP 14 w

4Cesko et al. (1998) [25]17MaleApex RV46XYPericardial effusionTOP 22 wStable

5 Cavallé-Garrido et al. (1997) [6]20LargeFemaleLateral wall below mitral valve (LV)Trisomy 18Ventricular septal defect, hydropsNoFetal death 26 w

6Cavallé-Garrido et al. (1997) [6]19SmallFemaleApex RVNoNoStable spontaneous resolution at 34 wAsymptomaticAsymptomatic at 22 months of life

7Cavallé-Garrido et al. (1997) [6]19SmallApex RVPericardial effusionPC 20 wStableAsymptomaticAsymptomatic at 12 months of life

8Cavallé-Garrido et al. (1997) [6]36SmallMaleLateral wall below tricuspid valve (RV)Pericardial effusionAsymptomatic at 18 months of life

9Johnson et al. (1996) [16]193 mmFemaleApex RV46XXPericardial effusionPC 20 wNo relapse after PC, no growthEutocic delivery 41 w; weight 3700 grams; asymptomaticAsymptomatic at 16 months of life

10Brachlow et al. (2006) [23]32Apex LVCardiomegalyNoStableAsymptomatic at 6 months of life

11Bernasconi et al. (2004) [26]2210 × 5 mmMaleLV lateral wall below mitral valve46XYPericardial effusionPC 22 wFetal death 26 w, probably due to diverticulum rupture

12 McAuliffe et al. (2004) [27]134 × 6 mmMaleApex RV46XYFirst trimester NT 4.2 mm
Pericardial effusion
PC 16 wResolution of the effusion; CD stableEutocic delivery 38 w; weight 3070 grams; asymptomaticAsymptomatic at 10 months of life

13McAuliffe et al. (2004) [27]134 × 3 mmMaleApex RV46XYFirst trimester NT 2 mm
Pericardial effusion
PC 14 wResolution of the effusion; CD stableEutocic delivery 38 w; weight 3150 grams; asymptomaticAsymptomatic at 8 months of life

14Prefumo et al. (2005) [1]145 × 5MaleApex RV46XYFirst trimester NT 3.7 mm; pericardial effusion, ascites, and skin edemaPC 16 wResolution of the effusion and hydrops; CD stable; mild cardiomegalyVaginal full-term eutocic delivery; asymptomaticAsymptomatic at 22 months of life

15Prefumo et al. (2005) [1]121 mmApex RVFirst trimester NT 1.2 mm Pericardial effusionNoSpontaneous resolution of PE with 21 w; CD stableFull-term eutocic delivery, asymptomatic Asymptomatic at 17 months of life

16Gardiner et al. (2005) [19]142-3 mmApex RVNormalPericardial effusionPC 14 wResolution of the effusion and hydrops; CD collapsedAsymptomatic at birth

17Gardiner et al. (2005) [19]142-3 mmApex RVNormalPericardial effusionTOP

18 Del Río et al. (2005) [18]135 × 5FemaleApex RV46XXPericardial effusion, septal defect AVNoSpontaneous resolution at 28 wEutocic delivery 40 w; weight 3400 grams, asymptomatic at birthCorrection of septal defect at 3 months of life, resection of diverticulum; asymptomatic at 8 months of life

19Wax et al. (2007) [14]206 × 9 mmMaleJunction base RV-infundibulumNoNoStableFull-term eutocic delivery; weight 3689 grams; asymptomatic; small permeable FOAsymptomatic at 18 months of life

20Koshiishi et al. (2007) [17]247 × 10 mmLateral wall below tricuspid valve (RV)Mild pericardial effusion; MC pregnancy with laser intervention for TTTS at week 20 where donor fetus died NoStablePrenatal fetal death at 29 w

21Pradhan et al. (2007) [28]28Apex LVFetal arrhythmia
Hydrops fetalis
Medical treatment (digoxin) Vaginal delivery 40 wAsymptomatic at 12 months of life

22Barberato et al. (2009) [29]165 × 5.7 mmApex LVMild pericardial effusion PC 20 wDiscrete enlargement of PE with normal heart functionPrenatal fetal death 37 w

23Barberato et al. (2009) [29]3012 × 13 mmMitral subvalvularLV dilatation and reduced systolic functionNoStableAsymptomatic at 6 months of life

24Davidson et al. (2006) [15]20Apex RVPericardial effusionNoSpontaneous resolution Surgical treatment

25 Williams  et al.(2009) [3]215 × 5.5 mmMaleRVPericardial effusionPC 24 wMild tricuspid regurgitation at 31; CD stableFull-term deliveryAsymptomatic at a year of life

26Perlitz et al. (2009) [30]227 × 4 mmMaleRV lateral wall NoNoStable, CD growth up to 9 × 9 mmEutocic delivery week 40; weight 4010 grams; asymptomatic at birthAsymptomatic at a year of life

27 Menahem (2010) [31]19Apex LVPericardial effusionNo controls performedFull-term live birthAsymptomatic at 10 months of life

28 Carrard et al. (2010) [32]132.6 × 2.9 mmMaleRV lateral wall 46XYFirst trimester NT 2.2 mm
Pericardial effusion
PC 17 wResolution after PC; CD collapsed at 26 wEutocic delivery 40 w, 2780 gramsAsymptomatic at 11 months of life

29 Abi-Nader  et al. (2009) [2]223-4 mmMaleRV46XYPericardial effusionNoResolution at 32-33 w PROM 34 w; Intubation due to prematurity; caesarean section; weight 2460 gr; 2 muscle IVCsAsymptomatic at 14 months of life

30Abi-Nader et al. (2009) [2]2111 × 15 mmMaleRV lateral wall below tricuspid valve IsolatedEutocic delivery; weight 2780 gr; asymptomatic at birthAsymptomatic at 16 months of life

31Abi-Nader et al. (2009) [2]2526 × 16 mm (37 s)MaleRVArrhythmia and reduced systolic function Induced deliveryCaesarean section 38 + 5 w; weight 3270 grams; mild reduction of systolic function and premature ventricular contractions at birthAsymptomatic at 3 years of life, on prophylactic treatment with acetyl salicylic acid

32 Williams et al. (2009) [3]17Apex LVNormalMesocardia, perimembranous IVCNoStableFull-term live birthAsymptomatic at 2 years of life

33 Paoletti  and Robertson (2012) [20]211.6 × 0.4 mmApex LVNormalDefect on thoracoabdominal midline TOP

34 Nam et al. (2010) [21]3112 mm (postnatal)RV lateral wall below tricuspid valveNoVentricular septal defectFull-term live birth; asymptomatic at birth; symptoms at 45 days of life: closure of septal defect at 3 months of lifeAsymptomatic at 10 months of life

35Our case142 mmMaleApex RV46XYPericardial effusionPC 17 wPE resolution after treatment; CD stable; moderate cardiomegaly; normal heart functionFull-term live birth; spontaneous eutocic delivery 40 + 1 w; weight 3150 gramsAsymptomatic at 4 years of life

GA di: gestational age at diagnosis; RV: right ventriculum, LV: left ventriculum; w: weeks of pregnancy; TOP: termination of pregnancy; PC: pericardiocentesis; CD: cardiac diverticulum; IVC: interventricular communication PE: pericardial effusion; PROM: premature rupture of membranes; NT: nuchal translucency.
Diagnosis was made during the pathological examination after death. Diagnosis of the ventricular septal defect was made after birth.