The Role of Ultrasound in the Prenatal Assessment of Congenital Pulmonary Valve Stenosis

doi:10.16048/j.issn.2095-5561.2025.03.12

Abstract：Objective: To explore the role of ultrasound in the prenatal diagnosis and assessment of congenital pulmonary valve stenosis (PS). Methods: A total of 25 fetuses suspected of having PS were selected from the General Hospital of the Northern Theater Command between January 2020 and December 2021. The gestational age was (29.3 ± 4.2) weeks, ranging from 25.1 to 33.5 weeks. Fetal echocardiography was performed before delivery. After birth, neonates underwent ultrasound examination to confirm the diagnosis of PS and assess its severity. The predictive value of fetal pulmonary valve orifice flow velocity, tricuspid regurgitation degree, pulmonary artery dilation, ductus arteriosus reverse flow, and cross-pulmonary artery for moderate to severe PS in newborns was analyzed. Results: All 25 fetuses were followed up. One case (4.0%) was terminated due to concurrent diagnosis of right ventricular hypoplasia, while 24 cases (96.0%) were delivered normally. Among the 24 neonates, 13 had no PS (54.2%), 4 had mild PS (16.7%), 4 had moderate PS (16.7%), and 3 had severe PS (12.5%). Four of the moderate to severe PS neonates underwent surgery, with 2 being followed up and 1 dying. The proportions of pulmonary valve orifice flow velocity >1.8 m/s, ductus arteriosus reverse flow, and moderate to severe tricuspid regurgitation were higher in moderate to severe PS neonates compared to those with mild or less PS, with statistically significant differences (P < 0.05). There was no statistically significant difference in the proportion of pulmonary artery dilation and cross-pulmonary artery between moderate to severe PS neonates and those with mild or less PS (P > 0.05). Conclusion: Fetal ultrasound has certain value in diagnosing PS. Pulmonary valve orifice flow velocity >1.8 m/s, ductus arteriosus reverse flow, and tricuspid regurgitation can be used as indicators to predict moderate to severe PS in newborns.