title: Late onset of large benign ductus arteriosus aneurysm presented with increased nuchal translucency and cystic hygroma at first trimester Down syndrome screening.
abstract: OBJECTIVE
  Fetal ductus arteriosus aneurysm (DAA) is a rare but potentially risky congenital heart disease. It is often not diagnosed until the third trimester because of its asymptomatic nature and late onset. In rare occasions, DAA may result in serious complications; therefore, prenatal diagnosis is helpful.
  
  
  METHODS
  Herein, we report the case of a foetus with cystic hygroma and increased nuchal translucency in the first trimester (but regressed at 20-week anomalous scan). Karyotyping indicated a 46 XY genotype. A large vascular mass was noted at the apex of the left lung by Doppler ultrasound at 38 weeks of gestation, with a diameter of 12.5 mm. After birth, echocardiography showed a patent ductus arteriosus with aneurysmal dilatation (17 mm as the largest diameter); thus, DAA was impressed. Chest computed tomography and three-dimensional angiography confirmed the large aneurysmal dilatation of the ductus arteriosus with a closed end at the pulmonary arterial side.
  
  
  CONCLUSIONS
  The male infant survived, but presented mild respiratory distress at birth. He was discharged at 24 days of age. At that time, DAA had regressed partially (diameter of 8.5 mm and much less blood flow), and it fully regressed at 40 days of age.
authors.affiliation: Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Horng-Der
authors.initials: HD
authors.lastname: Tsai
authors.affiliation: Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Kuanting
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Meng-Luen
authors.initials: ML
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Tze-Ho
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Wen-Hsiang
authors.initials: WH
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: mchen_cch@yahoo.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Chen
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging*; D004373:Ductus Arteriosus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D018191:Lymphangioma, Cystic / Q000000981:diagnostic imaging*; D008297:Male; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011264:Pregnancy Trimesters; D012075:Remission, Spontaneous; D018608:Ultrasonography, Doppler
keywords: ductus arteriosus aneurysm; nuchal translucency; three-dimensional computed tomography