Ventricular septal defect

Abstract Ventricular septal defects (VSD) are the most common cardiac defects (25%–30% of newborns), being frequently associated with more complex congenital heart defects (10% of fetuses with cardiac defects). The diagnosis of fetal VSD can be difficult, in particular for small and isolated VSDs, which must be actively sought on routine morphologic scans. Color and pulsed wave Doppler may be very helpful to establish the location and size of the VSD. Although the clinical prognosis of isolated VSD is usually good, an extensive workup is required to rule out chromosomal abnormalities, other structural abnormalities, and genetic syndromes present in 25%–35% of the cases. Inlet, perimembranous, malalignment, and large VSDs (>50% of the aortic lumen) are particularly associated with chromosomal abnormalities, whereas the risk is not increased for isolated muscular VSDs, especially in gestations with a normal first-trimester screening test for aneuploidies. Overall prognosis is good for isolated VSD. The obstetric management should not be changed; patients can deliver in their local hospital.