Case report of asymptomatic situs inversus totalis with dextrocardia in primigravida: Is cesarean section necessary?
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Jun 10, 2025
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Abstract
Introduction: Situs inversus, a congenital anomaly, is defined by the transportation of thoracic and abdominal organs. A variety during pregnancy this condition has often a challenge for obstetricians, gynecologists, and midwives as there is concern about cardiovascular dysfunction, leading to recommendations for cesarean section. Case Report: A 28-year-old primigravida at 40 gestational weeks. She was admitted arrival at the emergency room. Dextrocardia was already present, as was sinus inversus totalis and antenatal assessment relevealed no abnormalities. Patient underwent a spontanous vaginal delivery of a healthy male infant with normal birth weight. Discussion: Situs inversus totalis with dextrocardia does not compromise organ function or the typical physiological changes of pregnancy including cardiovascular system. Therefore, routine cesarean section is not indicated for these patients unless other obstetric factor necessitate it, as this condition does not independently contribute to increased maternal or fetal complications. Conclusion: Delivery of a pregnancy, dextrocardia, and situs inversus totalis via vaginal delivery is feasible without any significant cardiovascular risks. Cesarean section was not necessary unless other obstetric indications.
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How to Cite
Arifia, E., Putra, G. B., Wahyuni, A. and Rahmiati, N. (2025) “Case report of asymptomatic situs inversus totalis with dextrocardia in primigravida: Is cesarean section necessary? ”, Science Midwifery, 13(2), pp. 528-534. doi: 10.35335/midwifery.v13i2.1944.
References
Aljure Reales, V. D. J., Álvarez Gallego, G. C., Ávila Espitia, N. C., Arrieta Coley, A., & Ángel Suárez, O. G. (2017). Situs inversus totalis, topic review approach to Genetics and case report. Revista Colombiana de Cardiologia, 24(1). https://doi.org/10.1016/j.rccar.2016.06.016
Anggraini, W., Ivantarina, D., Yuliawati, D., & Yuniarti, F. (2021). Complete Midwifery Care In Very High-Risk Pregnancy. 10(1).
Bolcal, C., Kadan, M., Sicim, H., Ulubay, M., & Yildirim, V. (2019). Redo robotic cardiac surgery and concomitant cesarean section in a pregnant patient with dextrocardia and situs inversus totalis. Journal of Cardiac Surgery, 34(9), 863–866. https://doi.org/10.1111/jocs.14128
Calle, S., de Leeuw, M., Mpotos, N., Calle, P., & De Turck, B. (2016). A fatal combination of situs inversus, pregnancy and cardiac arrest treated with an automated external defibrillator. In Netherlands Heart Journal (Vol. 24, Issue 11). https://doi.org/10.1007/s12471-016-0851-5
Deepika, Wadhwa, L., Shekhar, C., Saini, J., & Chetani, M. (2016). Successful obstetric outcome in dextrocardia with situs inversus and moderate pulmonary hypertension-rare case. Journal of Clinical and Diagnostic Research, 10(10). https://doi.org/10.7860/JCDR/2016/20429.8749
Deshimo, G., Abebe, H., Damtew, G., Demeke, E., & Feleke, S. (2024). A Case Report of Dextrocardia with Situs Inversus: A Rare Condition and Its Clinical Importance. Case Reports in Medicine, 2024. https://doi.org/10.1155/2024/2435938
Devera, J., Licandro, F., Ramos, J., Taymoorian, H. T., & Yap, L. G. (2021). Situs Inversus Totalis in the Neonatal Setting. Cureus. https://doi.org/10.7759/cureus.13516
Edzie, E. K. M., Dzefi-Tettey, K., Cudjoe, O., Gorleku, P. N., & Adu, P. (2019). Incidental Finding of Dextrocardia with Situs Inversus in a 59-Year-Old Man. Case Reports in Radiology, 2019. https://doi.org/10.1155/2019/7107293
Eitler, K., Bibok, A., & Telkes, G. (2022). Situs Inversus Totalis: A Clinical Review. In International Journal of General Medicine (Vol. 15). https://doi.org/10.2147/IJGM.S295444
Enciu, O., Toma, E. A., Tulin, A., Georgescu, D. E., & Miron, A. (2022). Look beyond the Mirror: Laparoscopic Cholecystectomy in Situs Inversus Totalis—A Systematic Review and Meta-Analysis (and Report of New Technique). Diagnostics, 12(5), 1265. https://doi.org/10.3390/diagnostics12051265
Franqui-Rios, N., Garcia, Y., Ponce Health Sciences University, Ponce, Puerto Rico, Velazquez-Garcia, L., & Ponce Health Sciences University, Ponce, Puerto Rico. (2023). Dextrocardia with Situs Solitus in a Neonate – an Overview. Archive of Clinical Cases, 10(4), 171–174. https://doi.org/10.22551/2023.41.1004.10268
Gao, L., Zhang, J., Han, X., Hu, W., Sun, J., Tan, Y., Zhao, X., Hua, R., Wang, S., Zhang, Y., Wang, Y., & Wu, Y. (2020). A rare cardiac phenotype of dextrocardia observed in a fetus with 1p36 deletion syndrome and a balanced translocation: A prenatal case report. Molecular Cytogenetics, 13(1), 48. https://doi.org/10.1186/s13039-020-00514-1
Hill, C., Lindsay, D., & Aly, A. (2015). Dextrocardia with Situs Inversus, Atrio-ventricular and Ventriculararterial Concordance and a Left Posterior Aorta in a Preterm Twin Neonate. Journal of Pediatrics & Child Care, 1(2). https://doi.org/10.13188/2380-0534.1000008
Hur, M.-S., Chung, I.-H., & Lee, K.-S. (2014). Dextrocardia and Situs Inversus with Incomplete Inversion: A Case Report. Korean J Phys Anthropol, 27(4), 173–178. http://dx.doi.org/10.11637/kjpa.2014.27.4.173
Idowu, B., Okedere, T., & Onigbinde, S. (2020). Incidental discovery of situs inversus totalis in a 72-year-old man. West African Journal of Radiology, 27(1). https://doi.org/10.4103/wajr.wajr_41_18
Mehrotra, A., Sharma, A., & Kacker, S. (2022). Dextrocardia, situs solitus, double–inlet, and double-outlet left ventricle – A case report. Indian Journal of Child Health, 9(6), 108–112. https://doi.org/10.32677/ijch.v9i6.3489
Mikołajczyk, L., Respondek-Liberska, M., & Słodki, M. (2019). Prenatal dextrocardia: Cardiac and extracardiac anomalies in series of 18 cases from a single unit. Prenatal Cardiology, 2019(1), 28–32. https://doi.org/10.5114/pcard.2019.92707
Mozayan, C., & Levis, J. T. (2019). ECG Diagnosis: Dextrocardia. The Permanente Journal, 23(4), 18–244. https://doi.org/10.7812/TPP/18.244
Oztunc, F., Madazli, R., Yuksel, M. A., Gökalp, S., & Oncul, M. (2015). Diagnosis and outcome of pregnancies with prenatally diagnosed fetal dextrocardia. The Journal of Maternal-Fetal & Neonatal Medicine, 28(9), 1104–1107. https://doi.org/10.3109/14767058.2014.943659
Pidvalna, U., Mirchuk, M., Beshley, D., & Mateshuk-Vatseba, L. (2022). Morphometric characteristics of the aorta and heart in situs inversus totalis. Anatomy & Cell Biology, 55(2), 259–263. https://doi.org/10.5115/acb.21.252
Rao, P. S., & Rao, N. S. (2022). Diagnosis of Dextrocardia with a Pictorial Rendition of Terminology and Diagnosis. Children, 9(12), 1977. https://doi.org/10.3390/children9121977
Song, L., Fan, C., Zhang, H., Liu, H., Iroegbu, C. D., Luo, C., & Liu, L. (2021). Case Report: The Cox-Maze IV Procedure in the Mirror: The Use of Three-Dimensional Printing for Pre-operative Planning in a Patient With Situs Inversus Dextrocardia. Frontiers in Cardiovascular Medicine, 8, 722413. https://doi.org/10.3389/fcvm.2021.722413
Srikant, S., Dave, D., & Dave, D. (2021). Isolated Dextrocardia with Situs Solitus – Dextroversion in a Ugandan Baby: A Case Report. International Medical Case Reports Journal, Volume 14, 797–800. https://doi.org/10.2147/IMCRJ.S340185
Sule, M., Ma’Aji, S., Sa’Idu, S., & Shamaki, A. (2021). Dextrocardia with situs inversus: An incidental finding in a 9-year-old child. Sahel Medical Journal, 24(2). https://doi.org/10.4103/smj.smj_13_20
Taranikanti, M. (2018). Physiological Changes in Cardiovascular System during Normal Pregnancy: A Review. Indian Journal of Cardiovascular Disease in Women WINCARS, 03(02/03), 062–067. https://doi.org/10.1055/s-0038-1676666
Wang, X., Shi, Y., Zeng, S., Zhou, J., Zhou, J., Yuan, H., Wang, L., Shi, W., & Zhou, Q. (2017). Comparing levocardia and dextrocardia in fetuses with heterotaxy syndrome: Prenatal features, clinical significance and outcomes. BMC Pregnancy and Childbirth, 17(1), 393. https://doi.org/10.1186/s12884-017-1579-y
Xu, W., Wei, Y., Gao, X., Yang, X., Wang, L., Gao, W., Zhu, X., & Liu, B. (2023). The incidence and Risk Factors of fetuses with mirror-image dextrocardia with solitus inversus. https://doi.org/10.21203/rs.3.rs-3600749/v1
Yao, C., Wang, X., Zhang, J., Qiu, L., Ye, W., & Wang, C. (2019). Dextrocardia with complete AV block and the implantation of a temporary pacemaker before cesarean section: A case report. Medicine, 98(17), e15211. https://doi.org/10.1097/MD.0000000000015211
Yeo, L., Luewan, S., Markush, D., Gill, N., & Romero, R. (2018). Prenatal Diagnosis of Dextrocardia with Complex Congenital Heart Disease Using Fetal Intelligent Navigation Echocardiography (FINE) and a Literature Review. Fetal Diagnosis and Therapy, 43(4), 304–316. https://doi.org/10.1159/000468929
Zepeda‐Mendoza, C. J., Essendrup, A., Smoley, S. A., Johnson, S. H., Hoppman, N. L., Vasmatzis, G., Jackson, D. L., Kearney, H. M., & Baughn, L. B. (2021). Prenatal characterization of a novel inverted SMAD2 duplication by mate pair sequencing in a fetus with dextrocardia. Clinical Case Reports, 9(2), 769–774. https://doi.org/10.1002/ccr3.3608
Anggraini, W., Ivantarina, D., Yuliawati, D., & Yuniarti, F. (2021). Complete Midwifery Care In Very High-Risk Pregnancy. 10(1).
Bolcal, C., Kadan, M., Sicim, H., Ulubay, M., & Yildirim, V. (2019). Redo robotic cardiac surgery and concomitant cesarean section in a pregnant patient with dextrocardia and situs inversus totalis. Journal of Cardiac Surgery, 34(9), 863–866. https://doi.org/10.1111/jocs.14128
Calle, S., de Leeuw, M., Mpotos, N., Calle, P., & De Turck, B. (2016). A fatal combination of situs inversus, pregnancy and cardiac arrest treated with an automated external defibrillator. In Netherlands Heart Journal (Vol. 24, Issue 11). https://doi.org/10.1007/s12471-016-0851-5
Deepika, Wadhwa, L., Shekhar, C., Saini, J., & Chetani, M. (2016). Successful obstetric outcome in dextrocardia with situs inversus and moderate pulmonary hypertension-rare case. Journal of Clinical and Diagnostic Research, 10(10). https://doi.org/10.7860/JCDR/2016/20429.8749
Deshimo, G., Abebe, H., Damtew, G., Demeke, E., & Feleke, S. (2024). A Case Report of Dextrocardia with Situs Inversus: A Rare Condition and Its Clinical Importance. Case Reports in Medicine, 2024. https://doi.org/10.1155/2024/2435938
Devera, J., Licandro, F., Ramos, J., Taymoorian, H. T., & Yap, L. G. (2021). Situs Inversus Totalis in the Neonatal Setting. Cureus. https://doi.org/10.7759/cureus.13516
Edzie, E. K. M., Dzefi-Tettey, K., Cudjoe, O., Gorleku, P. N., & Adu, P. (2019). Incidental Finding of Dextrocardia with Situs Inversus in a 59-Year-Old Man. Case Reports in Radiology, 2019. https://doi.org/10.1155/2019/7107293
Eitler, K., Bibok, A., & Telkes, G. (2022). Situs Inversus Totalis: A Clinical Review. In International Journal of General Medicine (Vol. 15). https://doi.org/10.2147/IJGM.S295444
Enciu, O., Toma, E. A., Tulin, A., Georgescu, D. E., & Miron, A. (2022). Look beyond the Mirror: Laparoscopic Cholecystectomy in Situs Inversus Totalis—A Systematic Review and Meta-Analysis (and Report of New Technique). Diagnostics, 12(5), 1265. https://doi.org/10.3390/diagnostics12051265
Franqui-Rios, N., Garcia, Y., Ponce Health Sciences University, Ponce, Puerto Rico, Velazquez-Garcia, L., & Ponce Health Sciences University, Ponce, Puerto Rico. (2023). Dextrocardia with Situs Solitus in a Neonate – an Overview. Archive of Clinical Cases, 10(4), 171–174. https://doi.org/10.22551/2023.41.1004.10268
Gao, L., Zhang, J., Han, X., Hu, W., Sun, J., Tan, Y., Zhao, X., Hua, R., Wang, S., Zhang, Y., Wang, Y., & Wu, Y. (2020). A rare cardiac phenotype of dextrocardia observed in a fetus with 1p36 deletion syndrome and a balanced translocation: A prenatal case report. Molecular Cytogenetics, 13(1), 48. https://doi.org/10.1186/s13039-020-00514-1
Hill, C., Lindsay, D., & Aly, A. (2015). Dextrocardia with Situs Inversus, Atrio-ventricular and Ventriculararterial Concordance and a Left Posterior Aorta in a Preterm Twin Neonate. Journal of Pediatrics & Child Care, 1(2). https://doi.org/10.13188/2380-0534.1000008
Hur, M.-S., Chung, I.-H., & Lee, K.-S. (2014). Dextrocardia and Situs Inversus with Incomplete Inversion: A Case Report. Korean J Phys Anthropol, 27(4), 173–178. http://dx.doi.org/10.11637/kjpa.2014.27.4.173
Idowu, B., Okedere, T., & Onigbinde, S. (2020). Incidental discovery of situs inversus totalis in a 72-year-old man. West African Journal of Radiology, 27(1). https://doi.org/10.4103/wajr.wajr_41_18
Mehrotra, A., Sharma, A., & Kacker, S. (2022). Dextrocardia, situs solitus, double–inlet, and double-outlet left ventricle – A case report. Indian Journal of Child Health, 9(6), 108–112. https://doi.org/10.32677/ijch.v9i6.3489
Mikołajczyk, L., Respondek-Liberska, M., & Słodki, M. (2019). Prenatal dextrocardia: Cardiac and extracardiac anomalies in series of 18 cases from a single unit. Prenatal Cardiology, 2019(1), 28–32. https://doi.org/10.5114/pcard.2019.92707
Mozayan, C., & Levis, J. T. (2019). ECG Diagnosis: Dextrocardia. The Permanente Journal, 23(4), 18–244. https://doi.org/10.7812/TPP/18.244
Oztunc, F., Madazli, R., Yuksel, M. A., Gökalp, S., & Oncul, M. (2015). Diagnosis and outcome of pregnancies with prenatally diagnosed fetal dextrocardia. The Journal of Maternal-Fetal & Neonatal Medicine, 28(9), 1104–1107. https://doi.org/10.3109/14767058.2014.943659
Pidvalna, U., Mirchuk, M., Beshley, D., & Mateshuk-Vatseba, L. (2022). Morphometric characteristics of the aorta and heart in situs inversus totalis. Anatomy & Cell Biology, 55(2), 259–263. https://doi.org/10.5115/acb.21.252
Rao, P. S., & Rao, N. S. (2022). Diagnosis of Dextrocardia with a Pictorial Rendition of Terminology and Diagnosis. Children, 9(12), 1977. https://doi.org/10.3390/children9121977
Song, L., Fan, C., Zhang, H., Liu, H., Iroegbu, C. D., Luo, C., & Liu, L. (2021). Case Report: The Cox-Maze IV Procedure in the Mirror: The Use of Three-Dimensional Printing for Pre-operative Planning in a Patient With Situs Inversus Dextrocardia. Frontiers in Cardiovascular Medicine, 8, 722413. https://doi.org/10.3389/fcvm.2021.722413
Srikant, S., Dave, D., & Dave, D. (2021). Isolated Dextrocardia with Situs Solitus – Dextroversion in a Ugandan Baby: A Case Report. International Medical Case Reports Journal, Volume 14, 797–800. https://doi.org/10.2147/IMCRJ.S340185
Sule, M., Ma’Aji, S., Sa’Idu, S., & Shamaki, A. (2021). Dextrocardia with situs inversus: An incidental finding in a 9-year-old child. Sahel Medical Journal, 24(2). https://doi.org/10.4103/smj.smj_13_20
Taranikanti, M. (2018). Physiological Changes in Cardiovascular System during Normal Pregnancy: A Review. Indian Journal of Cardiovascular Disease in Women WINCARS, 03(02/03), 062–067. https://doi.org/10.1055/s-0038-1676666
Wang, X., Shi, Y., Zeng, S., Zhou, J., Zhou, J., Yuan, H., Wang, L., Shi, W., & Zhou, Q. (2017). Comparing levocardia and dextrocardia in fetuses with heterotaxy syndrome: Prenatal features, clinical significance and outcomes. BMC Pregnancy and Childbirth, 17(1), 393. https://doi.org/10.1186/s12884-017-1579-y
Xu, W., Wei, Y., Gao, X., Yang, X., Wang, L., Gao, W., Zhu, X., & Liu, B. (2023). The incidence and Risk Factors of fetuses with mirror-image dextrocardia with solitus inversus. https://doi.org/10.21203/rs.3.rs-3600749/v1
Yao, C., Wang, X., Zhang, J., Qiu, L., Ye, W., & Wang, C. (2019). Dextrocardia with complete AV block and the implantation of a temporary pacemaker before cesarean section: A case report. Medicine, 98(17), e15211. https://doi.org/10.1097/MD.0000000000015211
Yeo, L., Luewan, S., Markush, D., Gill, N., & Romero, R. (2018). Prenatal Diagnosis of Dextrocardia with Complex Congenital Heart Disease Using Fetal Intelligent Navigation Echocardiography (FINE) and a Literature Review. Fetal Diagnosis and Therapy, 43(4), 304–316. https://doi.org/10.1159/000468929
Zepeda‐Mendoza, C. J., Essendrup, A., Smoley, S. A., Johnson, S. H., Hoppman, N. L., Vasmatzis, G., Jackson, D. L., Kearney, H. M., & Baughn, L. B. (2021). Prenatal characterization of a novel inverted SMAD2 duplication by mate pair sequencing in a fetus with dextrocardia. Clinical Case Reports, 9(2), 769–774. https://doi.org/10.1002/ccr3.3608