Monday, 19 March 2018

Fetal VSD


33 year old married female
Gravida 1 Para 0
No significant past medical or surgical history.

Antenatal history:
Spontaneous pregnancy
Booked early in a private obstetric unit, subsequently transferred care to a public hospital for cost reasons.
Her antenatal blood investigations were unremarkable.
Non invasive prenatal test: Low risk, Male fetus
No OGTT was done.

Of significance are her fetal ultrasound scans showing a congenital cardiac anomaly that was first detected at 22 weeks gestation showing a ventricular-septal defect (Image 1) of 5mm in dimension (Image 2).


Image 1: 4 Chamber view of fetal heart on ultrasound with Doppler colour.
Arrow showing location of VSD.


Image 2: 4 Chamber view of fetal heart on ultrasound showing dimensions, 5mm VSD.


Labour course
Patient achieved a normal vaginal delivery at term. Live baby was born at birth weight of 3kg.

Working diagnosis:
Fetal Ventricular Septal Defect.

Management plan:
Will need paediatric cardiology and paediatric surgery involvement post delivery

Learning points:
Learning how to read a 4 chamber view on a normal ultrasound for a fetus.
Being able to identify fetal cardiac pathology.
Implications on this current pregnancy
Which are the appropriate specialities involves in post delivery care. 

 References:

Template for Case writeup

Below is a draft template that can be re-worked and re-utilized for multiple case write-ups.
As cases become more complex, the process can be refined and re-processed as required.


Fetal VSD

33 year old married female Gravida 1 Para 0 No significant past medical or surgical history. Antenatal history: Spontaneous preg...