To analyze the echocardiographic features and prognosis of fetal pulmonary artery sling (PAS).

In this retrospective study, clinical information of 13 PAS cases diagnosed by fetal echocardiography in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2018 were collected. Echocardiographic characteristics and complications of intracardiac and extracardiac malformations were summarized. Their outcomes were also analyzed.

(1) Two out of the 13 pregnant women continued their pregnancies until delivery, while the other 11 terminated the pregnancies. One neonate received surgery in another hospital after birth and was followed up to one year old with normal growth and development. The other infant was lost to follow up after birth. (2) Among the 13 cases, 12 were complete PAS and one (case 13) was partial PAS. Nine cases were complicated by other intracardiac malformations and five by extracardiac malformations. (3) Pulmonary artery development: Echocardiographic data of ten cases (the other three cases were excluded due to absence of detailed echocardiographic information) revealed that one fetus had tetralogy of Fallot with the diameter of pulmonary valve under normal value, while the pulmonary valve diameters of the other nine cases were all within the normal range. The inner diameter of the left and the right pulmonary artery that below the normal values were observed in four and two cases, respectively. One case showed absent distal end of right pulmonary artery with right pulmonary dysplasia, but the normal inner diameter at the beginning of right pulmonary artery.

Fetal PAS is more likely to be complicated by persistent left superior vena cava (PLSVC) and ventricular septal defect (VSD) as well as left and right pulmonary artery stenosis. The prognosis of PAS may be improved if operation is performed after birth, but further studies are needed.

Pulmonary artery; Congenital abnormalities; Ultrasonography, prenatal; Echocardiography; Prognosis