Prenatal Diagnosis of Pulmonary Arteriovenous Malformation With 3D / 4D STIC Fetal Echocardiography

Pulmonary arteriovenous malformation (PAVM) is a rare congenital vascular anomaly characterized by direct communication between the pulmonary artery and vein, resulting in a right-to-left shunt. Prenatal diagnosis remains uncommon. We report a fetal PAVM diagnosed at 21 weeks' gestation on fetal echocardiography. Color Doppler with graphic flow imaging demonstrated turbulent swirling flow within the right pulmonary vein, while spectral Doppler showed an arterialized pulmonary venous waveform. High-definition color Doppler and 3D/4D spatiotemporal image correlation (STIC) rendering confirmed a fistulous communication between the right pulmonary artery and vein. Prenatal recognition of PAVM is essential for serial surveillance, parental counseling, multidisciplinary perinatal planning, and early neonatal intervention.