Unguarded Tricuspid Valve and Pulmonary Atresia With Intact Ventricular Septum Complicated With Right Coronary Artery Fistula and Advanced Atrioventricular Block in a Fetus: A Case Report.

The unguarded tricuspid valve is a rare and severe condition. When found in the fetus, they mostly undergo abortion or intrauterine death. The details of the fetal course in such cases are poorly understood. Here, we report a case of an unguarded tricuspid valve detected at 20 weeks of gestation who developed a complete atrioventricular block and survived in utero. The fetus also had pulmonary atresia with intact ventricular septum, Uhl's disease, hypoplastic right ventricle, noncompacted left ventricle, valvular aortic stenosis, and right coronary artery fistula to the right ventricle. Despite this serious condition, the fetal hydrops did not develop. The baby was born at 33 weeks of gestation but died on day two. Our experience suggests that some babies may survive the fetal period even with the severe type of an unguarded tricuspid valve. Hence, efficient fetal and neonatal treatment strategies for fetal unguarded tricuspid valves are crucial.

Variations of placental migration in patients with early third trimester malposition.

AIM: This study aimed to investigate the impact of placental migration on the definitive prepartum diagnosis of patients with placenta previa (PP) and low-lying placenta (LLP) after late preterm. METHODS: This was a retrospective cohort study of singleton pregnancies with PP and LLP diagnosed at 30-33 weeks of gestation. We assessed the rate of changes in transvaginal ultrasonographic measurements of placental position during the period from 34 to 38 weeks of gestation. RESULTS: A total of 127 cases (82 of PP, 45 of LLP) were included. The PP group comprised 34 cases with complete PP and 48 with partial and marginal PP. The diagnosis of complete PP was changed to partial or marginal PP in two (5.9%) cases. Concerning cases with partial and marginal PP, 14 (29.2%) were eventually revised to LLP and four (8.3%) ultimately normalized. Among the patients with LLP, placental position was normalized in 23 (51.1%). Overall, a revision in diagnosis after late preterm was required in 48 cases (37.8%). Among the 93 patients who did not have complete PP, 46 (49.5%) needed revisions of their placental diagnosis. CONCLUSIONS: Repeated evaluations of placental position by ultrasonography after late preterm could be of significant value in selecting the most appropriate mode of delivery.