Antenatal diagnosis of pulmonary arteriovenous fistula using real-time ultrasound and color Doppler flow imaging

✍ Scribed by Roberto G. Kalugdan; Shoji Satoh; Takashi Koyanagi; Yuichi Shinzato; Hitoo Nakano

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 784 KB
• Volume: 17
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870170813

✦ Synopsis

The availability of real-time Doppler color flow imaging has made possible extensive progress in the antenatal diagnosis of fetal cardiovascular We report the accurate diagnosis of congenital pulmonary arteriovenous fistula complicated with hydrops fetalis, in utero, using this type of imaging.

CASE REPORT

A 26-year-old Japanese primigravida was referred to the Maternity Care Unit of Kyushu University Hospital because of a progressive polyhydramnios at 28 weeks, menstrual age.

On admission, a real-time ultrasound examination (Aloka SSD-280 featuring 3.5-MHz linear and sector transducers) revealed hydrops fetalis, as evidenced by massive ascites, cardiomegaly, pericardial effusion, and subcutaneous edema, together with polyhydramnios. A four-chamber view of the heart demonstrated atrial dilatation, particularly the left atrium, and increases in size of the cavities, as well as in thickness of the walls in both ventricles, thereby indicating cardiac enlargement with ventricular hypertrophy. Excessive flapping of the atrial septum corresponding to the anatomical site of the foramen ovale was noted (Figure 1). The main pulmonary artery originating from the right ventricle was dilated, along with subsequent dilatation of the right pulmonary artery and, in turn, the ductus From the *