Cardinal Clues Conducive to the Diagnosis of Fetal Absent Pulmonary and Aortic Valves in the First Trimester: A Case Report

Abstract

Fetal absent pulmonary valve (APV) is a rare cardiac lesion. Prenatal reports of absent aortic valve (AAV) are even scarce. Further, a combination of this lesions have never been reported in the first trimester. The objective of our case report is to describe the prenatal ultrasound features of a case of APV co-existing with AAV. Following the detection of hydrops at 12⁺² gestational weeks, a first trimester echocardiographic examination revealed situs solitus, sinus rhythm, normal septo-aortic continuity, presence of Ductus arteriosus, to- and fro-blood flow across both the pulmonary and the aortic orifices, ‘a’ wave reversal in the Ductus venosus, and reversed end diastolic flow in the umbilical artery; suggesting a diagnosis of APV with AAV. The couple opted for termination of the pregnancy. This case underscores the importance of meticulous utilization of color Doppler in the first trimester, especially in the background of increased nuchal translucency or hydrops.

Keywords

Absent pulmonary valve - Absent aortic valve - Pulmonary stenosis - Pulmonary artery dilatation - Pulmonary regurgitation - Absent Ductus arteriosus

Publication History

Received: 18 July 2017

Accepted: 05 January 2018

Article published online:
08 May 2023