Large fetal pulmonary arteriovenous malformation detected at midtrimester scan with subsequent high cardiac output syndrome and favorable postnatal outcome. Fetal Diagn Ther 2014;35(2):133-6
Date
01/10/2014Pubmed ID
24401867DOI
10.1159/000353913Scopus ID
2-s2.0-84896118900 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
Prenatal diagnosis of pulmonary arteriovenous malformations (PAVM), caused by abnormal communications between pulmonary arteries and pulmonary veins, is rarely described. We report a case of a PAVM between the right pulmonary artery and the left atrium, referred to our prenatal unit at 22 + 1 weeks of gestation, with severe cardiomegaly, dilation of the right pulmonary artery and a right pulmonary vein and retrograde flow in the ductus arteriosus. The fistula was located in the right lung and showed a broad, disturbed flow at color Doppler with high velocity and low pulsatility. The fetus was monitored weekly and cardiac function remained sufficient until 36 + 1 weeks of gestation, when increasing cardiomegaly prompted delivery by cesarean section. The newborn was transferred to the neonatal intensive care unit, intubated and the fistula was surgically removed. The boy could be discharged at the 43rd day of life and showed an uneventful course until the last follow-up at the age of 4 years, with no residual mental or physical handicaps and a normal cardiac function. Despite adverse outcomes described in previously reported cases of large PAVM complicated by severe cardiomegaly at midtrimester scan, our case had a good outcome.
Author List
Hellmund A, Berg C, Bryan C, Schneider M, Hraška V, Gembruch UAuthor
Viktor Hraska MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultArteriovenous Malformations
Cardiac Output, High
Female
Humans
Pregnancy
Prognosis
Pulmonary Artery
Pulmonary Veins
Ultrasonography, Prenatal
