The antenatal and postnatal prognosis for fetuses with chest noncardiac anomalies varies widely, depending of the type of lesion present. An important issue is to establish an accurate prenatal diagnosis, which allows an appropriate counseling of the couple, fetal karyotyping and eventually in utero fetal therapy, if possible. Also, another important feature is preparation for delivery in a tertiary center or an appropriate perinatal institution, able to provide care to the immediate neonatal consequences in such cases. The ultrasound exam is not only crucial in the diagnosis of such lesions, but also important in the serial antenatal follow up, some of them being progressive, and having the potential to lead to compromise of cardiac function and eventually to fetal death. Thus, the sonographer has an important role in the management of such difficult cases. Currently, perinatal centers provide multidisciplinary teams, with maternal fetal specialists, neonatologists, pediatric surgeons, all involved in counseling parents about the outcome and the management options for a fetus with a diagnosis of thoracic anomalies. Although the precise prenatal diagnosis is often possible, this does not necessarily ensure improvement of the postnatal outcome, due to associated pulmonary hypoplasia
