MATERNO-FETAL MEDICINE Associated anomalies and outcome of fetal aberrant right subclavian artery Ahmet Gul • Aytul Corbacioglu • Isil Turan Bakirci • Yavuz Ceylan Received: 3 January 2011 / Accepted: 4 April 2011 / Published online: 13 April 2011 Ó Springer-Verlag 2011 Abstract Purpose To determine the frequency of aberrant right subclavian artery among the low-risk fetuses and to eval- uate its association with chromosomal abnormalities and the other congenital heart diseases. Methods A total of 4,125 consecutive fetuses were examined for the presence of aberrant right subclavian artery that arises from the descending aorta distal to the left subclavian artery. Results Aberrant right subclavian artery was detected in 17 cases (0.4%). In nine cases it was an isolated finding. In four cases (23.5%) it was accompanied by another cardiac defect. Extracardiac malformations were present in three fetuses (17.6%). Among the 13 cases of aberrant right subclavian artery in which the karyotypes were known, one case presented with Down syndrome (7.6%). In this fetus, aberrant right subclavian artery was the only finding. Conclusion These findings suggest that aberrant right subclavian may be an isolated finding in trisomy 21. The visualization of subclavian artery should be a part of fetal echocardiographic examination as it may be a valuable marker for Down syndrome. Keywords Aberrant right subclavian artery Á Down syndrome Á Extracardiac anomalies Á Cardiac defects Á Ultrasound Introduction Aberrant right subclavian artery (ARSA) is the most common congenital abnormality of aortic arch with an incidence of 1.2% according to autopsy studies [1]. The right subclavian artery arises from the descending aorta distal to the left subclavian artery instead of the brachi- ocephalic artery. It is a benign pathology and usually asymptomatic. Rarely it causes dysphagia and airway narrowing because of its route behind esophagus and tra- chea [2, 3]. Recently, the ARSA came into prominence as an ultr- asonographic marker of chromosomal abnormalities [4–7]. The prenatal ultrasound studies have reported the incidence of ARSA in second trimester as 35% in trisomy 21 fetuses and 1.4% in chromosomally normal fetuses [4]. The purpose of this study is to determine the frequency of ARSA among the low-risk fetuses and to evaluate the association of ARSA with chromosomal abnormalities and the other congenital heart diseases. Materials and methods We investigated the course of the right subclavian artery during fetal echocardiography in 4,125 consecutive patients between 17 and 33 weeks of gestation. Routine transabdominal ultrasound examination was performed to the low-risk patients that attended our clinic between Jan- uary 2008 and October 2010. Voluson 730 Expert scanner and a 4–8 MHz probe (GE Helthcare, Milkwaukee, WI) were used for the examination and all women were examined by the same operator who was an obstetrician. During fetal echocardiography, the course of the right subclavian artery was observed after four-chamber view, A. Gul Á A. Corbacioglu (&) Á I. T. Bakirci Á Y. Ceylan Department of Obstetrics and Gynecology, Bakirkoy Women’s and Children’s Teaching and Research Hospital, Bakirkoy, Istanbul, Turkey e-mail: aytulcorbacioglu@gmail.com 123 Arch Gynecol Obstet (2012) 285:27–30 DOI 10.1007/s00404-011-1907-9