Prenatal screening and diagnosis of pulmonary artery anomalies: a review

International audienceCongenital pulmonary vascular anomalies are rare. Antenatal diagnosis of these vascular anomalies requires a good knowledge of fetal cardiac anatomy because clinical presentations are variable. In fact, screening of pulmonary arteries anomalies can be not complex in some cases because of important associated consequences easily detected on ultrasound, but some other anomalies have more discrete features. The severity depends on the underlying lesion and whether or not it is isolated. Moreover, they may be associated with genetic syndromes as well. The aim of this review is to define and review all unusual and abnormal situations of the main pulmonary artery and its branches and to propose, through the identification of "red flags" during routine antenatal heart examination, an optimal screening around the pulmonary pathway. Fourteen different antenatally diagnosed entities of pulmonary artery anomalies were defined. Those entities belonging to the four following family of disorder: 4 anomalies of the pulmonary valvular region with stenosis or atresia of the valve; 4 anomalies related to conotruncal abnormalities; 4 anomalies associated with the abnormal origin or pathway of the pulmonary artery; and finally, 2 anomalies belonging to primitive abnormal development of the pulmonary artery and its branches. We highlight the need to differentiate three-vessel and three-vessel and trachea views when assessing a fetus with an abnormality belonging the CPA family spectrum