Challenges in prenatal care of ectopic cordis: Case series and literature review

Ectopic cordis (EC) is an exceptionally rare anomaly in which the fetal heart lies outside the thoracic cavity, making prenatal recognition essential. We describe 2 prenatally diagnosed cases managed at our tertiary center. The first case involved a 17-year-old primigravida carrying a 36-week female fetus with complete EC and an intact diaphragm. The second case concerned a 27-year-old primigravida whose 35-week female fetus exhibited partial EC, a ventricular septal defect, lower sternal cleft, and an omphalocele consistent with Pentalogy of Cantrell. After cesarean delivery and temporary heart coverage, the first neonate died on day 12, whereas the second neonate survived and was discharged on day 10 following conservative stabilization. These contrasting outcomes show that prognosis hinges on the degree of cardiac displacement and accompanying defects, underscoring the importance of early prenatal detection and coordinated multidisciplinary care to optimize outcomes.