The purpose of this study is to suggest the importance of precise observation of cardiac axis and cardiovisceral situs on transvaginal ultrasonography. The authors report 2 cases of major cardiac malformation diagnosed at the first trimester by right cardiac axis on the transvaginal ultrasonography. Two cases of dextrocardia were corrected transposition of the great arteries with absent right atrioventricular connection and complete atrioventricular septal defect with severe pulmonary stenosis associated with left isomerism. Left-sided stomach with right cardiac axis on transvaginal screening sonography can be a key finding in the early diagnosis of major cardiac malformations.
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