Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
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Ultrasound Obstet Gynecol · Jul 2006
Case ReportsDevelopment of hypoplastic left heart syndrome after diagnosis of aortic stenosis in the first trimester by early echocardiography.
We describe a case of aortic stenosis in the first trimester that progressed to hypoplastic left heart syndrome. At 11 + 3 weeks' gestation the four-chamber view was normal but evidence of increased aortic blood velocity prompted the diagnosis of aortic outflow obstruction. At 16 + 6 weeks' gestation the left ventricle was hyperechogenic, globular and dysfunctional, suggesting the development of hypoplastic left heart syndrome. ⋯ Postnatal intervention included a Norwood I operation performed on the 5th postnatal day. We have shown the feasibility and utility of early fetal echocardiography and that a left heart obstruction diagnosed in the first trimester can progress to left heart hypoplasia during the early second trimester. This information is important for planning prenatal and perinatal management.