This was a 20 year old lady , primi, has undergone 3 scans earlier at different  centres; the last one was done 3 weeks ago and everything appeared normal till then . Now she was referred  to rule out cardiac anomaly.

The following was seen :

cardiomegaly seen

normal LVOT seen

NORMAL 3 VESSEL VIEW

NORMAL AORTIC VALVE DOPPLER

SIGNIFICANT MITRAL REGURGITATION SEEN

mitral regurgitation

significant tricuspid regurgitation

TRICUSPID AND MITRAL REGURGITATION SEEN

MILD PULMONARY REGURGITATION

PULM VEIN DRAINING INTO LEFT ATRIUM

FLOW REVERSAL OF DUCTUS VENOSUS

UMBILICAL ARTERY SHOWS HIGH R.I. AND P.I. FOR THE GA ( 39 WEEKS)

MIDDLE CEREBRAL ARTERY SHOWS HIGH PEAK SYSTOLIC VELOCITY OF 89.1 CMS/S ; M.O.M. WAS AROUND 1.59 SUGGESTIVE OF SEVERE FETAL ANEMIA

NORMAL SITUS SEEN

RECONSTRUCTED IMAGE OF HEART WITH AORTIC ARCH

THIS FETUS HAD SEVERE FETAL ANEMIA WITH CARDIAC FAILURE  LEADING TO CARDIOMEGALY WITH MITRAL, TRICUSPID AND PULMONARY REGURGITATION .NO OTHER OBVIOUS CARDIAC ANOMALY WAS MADE OUT . THE VENO ATRIAL , ATRIO VENTRICULAR AND VENTRICULO ARTERIAL CONCORDANCE APPEARED TO BE NORMAL; NO SEPTAL DEFECT WAS MADE OUT.

ALL THESE HAVE DEVELOPED WITHIN THE LAST 3 WEEKS .

AS GOOD NEONATAL MANAGEMENT WAS IMPERATIVE THE PATIENT WAS REFERRED TO A HIGHER CENTRE.