Hypoplastic Left Heart Syndrome Prenatal Ultrasonographic Diagnosis of Hypoplastic Left Heart Syndrome

Abstract

Prenatal ultrasonographic diagnosis of fetal hypoplastic left heart syndrome in primigravidarum pregnancy was reported. The patient has a history of anticonvulsant ingestion in the first trimester because of epileptic disease. Ultrasonographic features included a small size of the left side of the heart, especially the left ventricle size decreased. The left atrium was small relative to the right atrial size with a paradoxical movement of the blood flow from the left to the right atrium. The compensatory dilated pulmonary trunk was seen adjacent to the superior venacava with a non-visible or hypoplastic aortic arch. Color Doppler showed the reversal of flow across the aortic isthmus and transverse aortic arch. Confirming diagnosis and counseling by maternal fetal medicine specialist and pediatric cardiologist was done. The patient requested for termination of pregnancy after counseling. Autopsy of the heart confirmed for diagnosis of hypoplastic left heart syndrome.