“…Pulmonary agenesis, particularly when bilateral, may be difficult to detect on imaging. Previous reports have documented missed bilateral pulmonary agenesis 8 9 on prenatal imaging, where only subtle findings of heart predominance in the thoracic cavity, slight deviation in the cardiac axis, and an elevated diaphragm were seen. Additional imaging modalities such as magnetic resonance imaging, fetal echocardiogram, and Doppler imaging, in addition to reevaluation at a later gestational age, have shown to be effective in demonstrating the lack of lung parenchyma and pulmonary vasculature.…”