Figure 1. Ultrasound photos performed at the joint of anomalies. Top Left: Image of 4 chambers view with the presence of dilatation of the venous sinus characteristic of PLSVC. Top right: Right ventricular outflow tract with presence of adjoining vessel in the left hemithorax. Bottom left: Abnormal 3VT section with presence of a fourth vessel on the left with dilation and Doppler flow. Bottom right: Connection of the PLSVC to the cervical hemangioma.

She was evaluated again in a meeting at 31.2 weeks. In this evaluation, there were no changes regarding to the size of the lesion, nor a secondary obstructive effect, for which it was decided a follow up with a biophysical profile in 3 weeks and a new assessment by the fetal anomalies board in 5 weeks to define the route and time for delivery.

At 35.3 weeks, the patient attended to the emergency department of the Colombia University Clinic, referred from an outpatient control ultrasound for finding a hydropic fetus without fetal heart rate. Upon admission, fetal death was verified and by the patient’s desire it was decided to perform a cesarean section for the end of the pregnancy. A female dead newborn was obtained during the procedure, with effacelation on the thorax, abdomen, upper and lower extremities, overlapping sutures, and a 6 x 4 cm left cervical mass (FIGURE 2). The weight of the gestation product was 1,970 grams, with a height of 42 cm and an APGAR score of 0/0/0. The patient was discharged 24 hours after the procedure due to adequate clinical evolution.