Table 3 Prenatal and postnatal course of recipients with pulmonary stenosis.
| Recipient | Postnatal cardiac diagnosis | GA at LC (weeks) | Recipient findings | Donor | GA at delivery (weeks) | Postnatal course | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fetal echocardiography | TR | MR | DVnegA | IU PS | UA velocity | UA velocity | Echocardiography | |||||
| 1 | Severe PS | 18+5 | Normal; week 20+5: normal; week 29: valvar PS, small valvar annulus | − | − | − | + | UAEDF normal, PI normal | UAEDF normal | Normal; fetal death 5 days after LC | 33+5 | Severe PS requiring balloon valvoplasty at ages 1 and 9 months; normal valve morphology; residual mild PS (32 mm Hg*) |
| 2 | Severe PS | 20+3 | CHF | + | + | + | − | UAEDF normal, PI normal | UAEDF negative | Normal; fetal death 1 day after LC | 39+0 | Progression from moderate (Pmax 68 mm Hg*) to severe PS (Pmax 90 mm Hg*) within 4 months, no TR, small pulmonary annulus of 7 mm at 4 months, thickening of pulmonary valve leaflets; balloon valvoplasty at 4 months; residual mild PS of 30 mm Hg* |
| 3 | Moderate PS | 19+0 | Mild CHF | + | − | + | − | UAEDF normal, PI normal | UAEDF normal | Normal | 35+1 | Postpartum systolic heart murmur; moderate PS (Pmax 40 mm Hg*), thickening of pulmonary valve leaflets |
| 4 | Mild supravalvar stenosis | 19+4 | CHF | + | + | + | − | UAEDF normal, PI normal | UAEDF normal | Normal | 35+4 | Mild increase in velocity within the pulmonary trunk (1.8 m/s) |
*Instantaneous pressure measured by the Bernoulli equation of echocardiography.
CHF, congestive heart failure; GA, gestational age; IU, intrauterine; LC, laser coagulation; MR, mitral valve regurgitation; PI, pulsatility index of the umbilical artery; Pmax, maximum pressure gradient; PS, pulmonary stenosis, UA, umbilical artery, UAEDF, umbilical artery end diastolic flow.