Accuracy of fetal echocardiography in detecting lesions associated with, and predicting surgical plan for, dextro‐transposition of the great arteries and double outlet right ventricle with subpulmonary ventricular septal defect and predicted transposition physiology

Challenges remain in the accurate diagnosis and prediction of the postnatal surgical plan in fetuses with complex D-TGA and DORV-SPV. The assessment of qualitative VSD size description changed frequently over serial FE evaluations, and between final FE and postnatal echocardiogram, with small defects often not requiring repair. Aortic and aortic-to-pulmonary ratio measurements in fetuses with D-TGA or DORV-SPV appear to have improved the discriminatory ability in identifying cases that undergo postnatal CoA repair relative to fetuses with isolated CoA. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.