EP10.22: Prenatal diagnosis of pulmonary stenosis

Abstract

Pulmonary stenosis is obstruction of the right ventricular outflow tract caused primarily by narrowing of the infundibulum or valve stenosis. Right ventricular outflow tract obstructions with an intact ventricular septum account for about 1–5% of all fetal congenital heart disease. Patient referred to fetal echocardiography after abnormal ultrasound. Fetal echocardiography demonstrated: hypoplastic right ventricle, with hypertrophic wall, increased right atrium and pericardial effusion. Pulmonary valve was thickned and with low mobility. After pulmonar valve, there was a proximal dilatation of pulmonar artery. The flow throw pulmonar valve was manteined antegrade only few milimeters from the valve, demonstrating small valve permeability. Both branches from the pulmonary arteries were demonstrated in a three vessel view. Colour Doppler highlights the presence of tricuspid regurgitation, a reverse flow into ductus arteriosus. an abnormal Ductus venosus blood flow. Prenatal diagnosis is uncommon and include assymetry in ventricular size, right atrial enlargement, thickening of the pulmonar valve and Doppler abnormalities. Routine ultrasonography does not detect mild or moderate pulmonar stenosis. Delivery should occur in a terciary centre with cardiology backup and prostaglandine infusion. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.