Year: 2009
Type: conference-abstract
Abstract: Examination of the fetal venous system plays an important role in fetal anomaly screening. About 20–30% of the oxygenated blood from the placenta is transported from the umbilical vein (UV) through the ductus venosus (DV) into the inferior vena cava (IVC), through the foramen ovale directly into the left heart. Abnormalities of the umbilico-portal system have been reported to be associated with cardiac anomalies, cardiac failure and fetal hydrops. We present a report of such a case. Mdm IBM is 33 year-old, G5, P4 had a screening scan at 20 weeks that showed an unusual course of UV, traversing anteriorly and superiorly with the (R) & (L) portal veins branching at the same level. The typical DV segment which is supposed to arise from the portal sinus is not seen at its usual site. Instead, a long and dilated segment with biphasic flow on Doppler is seen. This drains into the (R) atrium. No cardiomegaly or dilated IVC was noted. Serial ultrasound examinations were performed to detect early hydrops and cardiomegaly, which were absent. Karyotype was normal, 46,XX. Baby was delivered at 37 weeks. Postnatally baby is well. 2D echocardiography showed small to moderate VSD (ventricular septal defect) 3.4mm. Abdominal ultrasound showed a thrombosed proximal UV, and the distal UV had abnormal communications with both right and left portal veins. There is portal venous flow demonstrated from the portal veins into a shunt (continuation of UV) which later drains superiorly into the left hepatic vein. Hospital birth defect database was searched. 3 cases of fetuses with ductus venosus anomalies different from the above case described were found. All 3 cases were absent ductus venosus. This is an unusual case of abnormal umbilico-portal venous circulation which was prenatally detected on routine screening scan. Follow-up monitoring did not show any features of cardiac failure.
DOI: 10.1002/uog.7205
Authors: T. Foo, Y. L. Yan, X. J. Zhang, L. S. Khoo, J. V. Tan, G. Yeo
Institution: KK Women's and Children's Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2038095259