A 34-year-old woman (G2P1) with non-contributive history was sent to our office at 19 weeks, 5 day of gestational age due to abnormal appearance of the fetal lungs.

Our examination revealed hyperechoic, homogeneous, enlarged fetal lungs, with medial shift of the heart, dilated bronchial tree, and massive ascites. Diagnosis of laryngeal (or tracheal) atresia was determined. The parents opted for the termination of the pregnancy and the diagnosis was confirmed consequently.

Here are some of the ultrasonographic images that we obtained.

Images 1-4: 19 weeks, 5 day of gestational age; the images show coronal scans of the fetal thorax with hyperechoic, homogeneous, bilateral enlargement of the lungs. Dilated bronchial branches can be seen. At the level of the fetal abdomen a massive ascites is present.

 

 

Images 5, 6: 19 weeks, 5 day of gestational age; transverse scan of the fetal thorax with medially shifted and compressed heart.

 

Images 7, 8: 19 weeks, 5 day of gestational age; color Doppler transverse (Image 7) and sagittal (Image 8) scans of the fetal thorax with medially shifted and compressed heart.

 

Image 9: 19 weeks, 5 day of gestational age; transverse scan of the fetal abdomen showing massive ascites.



Images 10-14: 19 weeks, 5 day of gestational age; 3D scans of the fetal thorax and abdomen showing bilateral enlargement of the lungs (depicted in pink color - number 1 on colorized images 11 and 13) and massive ascites (depicted in blue color - number 4 on colorized images 11 and 13). 

1 - lungs; 2 - liver; 3 - bowels; 4 - fetal abdominal cavity dilated with ascites.