Prenatal therapy of non-immunologic hydrops fetalis caused by severe aortic stenosis

Congenital aortic stenosis is a rare cause of congestive heart failure and hydrops fetalis. This report describes a case of prenatally diagnosed criti cal aortic stenosis and endocardial fibroelastosis leading to a severe hydr ops fetalis at 27 weeks of gestation. Successful transplacental digitalizat ion was performed and all signs of hydrops resolved within 2 weeks. The pre gnancy continued with normal development of the fetus and birth was induced at 39 weeks of gestation. After an uneventful vaginal birth, the child was transferred for cardiac catheterization, and balloon dilation of the aorti c valve was performed successfully. Follow tip at the age of 2 years showed only mild left ventricular cardiac hypertrophy: a moderate elevated pressu re gradient of 50 mmHg at the aortic valve and mild aortic and mitral regur gitation. No further interventions were necessary at this point.