How is pulmonary atresia with intact ventricular septum diagnosed prenatally?

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Pulmonary atresia with intact ventricular septum is diagnosed before birth when the pulmonary valve is absent or severely narrowed, preventing flow from the right ventricle into the pulmonary artery, while the ventricular septum remains intact. In fetal imaging you typically see a small right ventricle and little to no forward flow across the pulmonary valve on Doppler. The left heart and other chambers are usually normal, and there is no VSD. This combination of an atretic or severely stenotic pulmonary valve with an intact septum and a small right ventricle is what distinguishes this condition on prenatal ultrasound. The other scenarios describe different heart lesions that don’t fit this pattern.