Prenatal diagnosis and postnatal management of a complicated pulmonary valve stenosis: a case report.

BACKGROUND

Pulmonary stenosis (PS) is a common congenital heart defect, often detectable prenatally via fetal echocardiography. This case report describes a fetus diagnosed at 19 weeks with severe valvular PS. Postnatal balloon valvuloplasty was successfully performed via jugular access due to femoral obstruction.

CASE PRESENTATION: A 34-year-old pregnant woman was referred at 19 weeks due to increased fetal nuchal translucency, and fetal echocardiography revealed severe pulmonary stenosis with right ventricular hypertrophy and tricuspid regurgitation. After full-term vaginal delivery, the neonate's diagnosis was confirmed, and progressive stenosis necessitated balloon valvuloplasty via jugular access due to lower venous obstruction. Post-procedure infundibular stenosis was managed medically with propranolol, resulting in significant gradient reduction, and the infant remains well on follow-up.

CONCLUSION

This case highlights the importance of fetal echocardiography, alternative venous access, and multidisciplinary care in achieving good outcomes in complex congenital heart disease.