Between 1991-1995 five cases of fetal critical aortic stenosis were diagnosed by fetal echocardiography at the Polish Mother's Memorial hospital. The main cause for referral for fetal ECHO was fetal ascites detected during routine obstetrical ultrasound scan in four cases and positive family history in one case. Pregnant women had fetal echocardiography monitoring as in-patients. During the first examination, the mean aortic valve size was 3.9 mm, mean shortening fraction of LV was 15.8%, mean heart/chest area ratio was 0.51. In one case pharmacological treatment with digoxin (due to fetal congestive heart failure) and steroids (to stimulate fetal lung maturity) was introduced. Amniocentesis due to severe polyhydramnios and fetal ascites drainage were also performed in this case. The were 2 fetal demises at 26 and 28 weeks of pregnancy, 3 cesarean section due to fetal distress during the first period of labour. The pH of umbilical blood was > 7.2. The newborns died between days 2-4 of life.
Conclusions: Aortic valve stenosis can be diagnosed prenatally. This type of fetal heart defect has a poor prognosis.