Francois Manson, MD.

Fécamp, France.

Case report

A 32-year-old P0G1, with normal first and second trimester ultrasonography outcomes, presented at 33 weeks. Following findings were discovered.

Images 1 and 2: Image 1 shows five-chamber view of the heart with narrowing of the aortic ring (3.8 mm), with unusually thicken aortic valves (arrows). LV = left ventricle, AAO = ascending aorta. Image 2 shows color Doppler flow at the same level as in image 1. Note the turbulent flow above the aortic valves (the peak velocity was 3.85 m/s - not shown at image).

Images 3 and 4: Image 3 shows the origin of the aorta with its poststenotic dilatation (*) just above the aortic valves (arrows). Image 4 shows slightly different view of the valvular aortic stenosis (arrow).

Image 5: 3-vessels view showing an unusual enlargement of the aorta compared with the normal diameter of the pulmonary artery.

Image 6 and 7: Color Doppler 3-vessel view - "red flow" represents the flow within the pulmonary artery and the turbulent flow can be seen within the aorta.

Image 8: Four-chamber view looked normal.

A severe HELLP syndrome developed in the mother and the pregnancy was terminated by a cesarean section in 34th week of gestation. The baby weighted 1980 g and the diagnosis of the valvular aortic stenosis due to dysplasia of the aortic valves was confirmed postnatally and during surgical valvuloplasty.