Ductus arteriosus aneurysm (DAA) is a rare vascular anomaly in newborns. It is typically asymptomatic and self-limiting but there is a risk of thrombosis or rupture so an accurate diagnosis is vital. This study presents the case of a male neonate who was delivered at 38 weeks and two days of gestation and who presented with respiratory distress at birth. Prenatal ultrasonography using three-dimensional (3D) power Doppler (3DPD) and high-definition flow imaging (HDFI) identified a DAA and successfully differentiated it from other thoracic anomalies. The infant was managed conservatively for respiratory symptoms and follow-up postnatal echocardiography confirmed spontaneous resolution of the aneurysm. This case demonstrates that prenatal 3D cardiac power Doppler and HDFI provides critical spatial information about vascular architecture and increases diagnostic confidence and facilitates appropriate perinatal management.
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