Case of the Week #532

Frantisek Grochal

Affiliation: Femicare - Center of prenatal ultrasonographic diagnostics, Kollarova 17/A, 036 01 Martin, Slovak Republic

Posting Dates: March 7, 2021 - March 24, 2021

Case Report: A 22-year-old woman (G1P0) with non-contributory medical history was sent to our office at 12 weeks gestation for a routine first-trimester ultrasound.

Our examination found a live fetus with Crown Rump Length (CRL) 48.6mm, corresponding to 11 weeks + 5 days of pregnancy. Prominent nuchal translucency was the first striking discovery and additional examination revealed following findings:

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Answer

We present a case of pulmonary atresia with intact ventricular septum (PAIVS).

Our ultrasound images showed:

  • Increased nuchal translucency measuring 5.4 mm
  • Hypoplastic right ventricle of the heart with severe tricuspid regurgitation
  • Pulmonary artery was filled in a reversed fashion via the ductus arteriosus

The parents opted for termination of pregnancy.

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Image 3: LV-left ventricle; RV-right ventricle; LA-left atrium; RA-right atrium
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Image 5: LV-left ventricle; RV-right ventricle; LA-left atrium; RA-right atrium
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Image 6: LV-left ventricle; Ao-aorta
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Image 7: PA-pulmonary artery; Ao-aorta
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Image 8: PA-pulmonary artery; Ao-aorta; DA-ductus arteriosus
Video 1: LV-left ventricle; RV-right ventricle; LA-left atrium; RA-right atrium
Video 2: Color doppler showing tricuspid regurgitation. PA-pulmonary artery; Ao-aorta; DA-ductus arteriosus

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