A 33-year-old, healthy, G3 P1 woman had had a routine obstetrical ultrasound done at 19 weeks of gestation, which reportedly was normal. Because of decreased fetal activity, a repeat obstetrical ultrasound was performed at 32 weeks. That study showed polyhydramnios and a low biophysical profile, prompting transfer to a high-risk obstetrical center. The fetal echocardiogram, done on the same day, revealed a markedly abnormal heart. The heart looked structurally normal, but the aortic annulus, ascending aorta, transverse arch, descending aorta, main pulmonary artery, and coronary arteries were unusually echo-dense. Both ventricles were dilated, and biventricular function …