Consultant Fetal Maternal medicine, Surat, India

Case report

Primigravida 18-year-old with non contributory history, was referred for second opinion for suspected congenital Heart anomaly at 22 weeks of gestation.Our examination revealed the following findings:

-Situs Solitus;-Veno-atrial connections: concordant;
-Atrio-ventricular connections: concordant;
-Ventriculo-arterial connections: concordant;
-LVOT: Perimembranous ventricular septal defect with overriding of Aorta (TOF variant);
-RVOT: small main pulmonary artery with absent/ unguarded/ dysplastic pulmonary valve resulting into dilated branched pulmonary arteries suggestive of absent pulmonary valve syndrome;
-Arch view: absent ductus arteriosus (ADA);
-No significant MAPCAs noted;

The diagnosis was confirmed after birth.

Images 1-3: 2D and color Doppler images showing dilated right and left pulmonary arteries.

Image 4: spectral Doppler shows increased velocities in the main pulmonary artery, which is stenotic and incompetent.

Images 5 and 6: 2D and color Doppler of 4-chamber view showing normal pulmonary veins draining into left atrium.

Images 5 and 6: 2D and color Doppler showing the perimembranous ventricular septal defect.

Images 7 and 8: color Doppler images showing absent ductus arteriosus.

Videos 1-3: 2D images of the fetal heart showing dilated right and left pulmonary arteries, dysplastic pulmonary valve, perimembranous septal defect and overriding aorta.