TY - CHAP M1 - Book, Section TI - Pulmonary Stenosis and Atresia A1 - Bianchi, Diana W. A1 - Crombleholme, Timothy M. A1 - D'Alton, Mary E. A1 - Malone, Fergal D. PY - 2015 T2 - Fetology: Diagnosis and Management of the Fetal Patient, 2e AB - Key PointsPulmonary stenosis and atresia refer to congenital narrowing or complete occlusion of the right ventricular outflow tract respectively.It may occur in isolation or as part of Williams or Noonan syndrome, or secondary to teratogenic exposure such as congenital rubella syndrome.Prenatal diagnosis relies upon identification of asymmetry in ventricular size, right atrial enlargement, thickening of the pulmonary valve and Doppler abnormalities across the pulmonary valve.Obstetric management generally does not need to be changed following this diagnosis, although in cases of critical pulmonary stenosis or atresia, delivery should occur in a controlled manner in a center with pediatric cardiology backup and ability to provide prostaglandin infusion.Neonatal management depends on the pressure gradient across the pulmonary valve, with invasive intervention reserved generally for those cases with pressure gradients greater than 30 to 50 mm Hg.While open surgical valvotomy or valve replacement represents definitive treatment, contemporary management is moving toward percutaneous approaches using balloon valvuloplasty and valve replacement. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - obgyn.mhmedical.com/content.aspx?aid=1106398066 ER -