Prenatal ultrasound diagnosis of hypoplastic left heart syndrome in utero associated with hydrops fetalis

Ultrasound is widely used in obstetrics as a screening technique for fetal size and maturity, placental structure and function, and for detection of fetal congenital malformations in complicated pregnancies.^1-3 Our own work on qualitative and quantitative fetal echocardiography^4,5 and the work of others⁶ has suggested that high resolution ultrasound can be used to assess fetal heart rhythm and function, and can detect congenital heart malformations before birth. In this report, we delineate prenatal diagnosis of hypoplastic left heart syndrome in a fetus with signs of hydrops fetalis, who was found after cesarean section to have associated trisomy 13. Additionally, we diagnosed the ususual occurrence of an intraventricular thrombus within the hypoplastic left ventricular cavity. The fetal ultrasound evaluation was of major importance in the perinatal management of both mother and unborn child.