1. HKSUM CME program November 2009 Acknowledgement: Hye-Sung Won M.D Department of Obstetrics and Gynecology University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

2. Case Anomaly scan at 20 weeks’ gestation FCV Color DopplerPW Doppler RA RV LA LV RV RA Velocity>2.5m/s 4 Chamber view

3. Ao PA SVC Right atrium size: 10.6*14.0mm Pulmonary artery: size : 2.5mm, laminar flow Cordocentesis : normal karyotype RA RV LV PA Ao 3 vessel view 4 Chamber view Color Doppler

4. Rescan at 31 weeks’ gestation RA RV LV LA RV RA LV PA Ao SV C 3 Vessel view 4 Chamber view Color Doppler

5. Questions 1.What are the abnormal ultrasonographic fi ndings? 2. What is the likely diagnosis? 3. What is the differential diagnosis?