Absent ductus venosus: case series from two tertiary centres

Maruotti, Giuseppe Maria; Saccone, Gabriele; Ciardulli, M. D. Andrea; Mazzarelli, Laura Letizia; Berghella, Vincenzo; Martinelli, Massimo

doi:10.1080/14767058.2017.1344637

Cited by 14 publications

(11 citation statements)

References 35 publications

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“…Hydrops and cardiac failure may result from other mechanism, such as portal hypertension [9,16]. Prognosis is relatively good in this subtype [13,15,17]. In the present series, there were two intrahepatic drainages, and one of this baby is now eight month.…”

Section: Discussionmentioning

confidence: 51%

Prenatal diagnosis of ductus venosus agenesis: a retrospective study of associated cytogenetic/congenital anomalies

Özsürmeli¹,

Sucu²,

Arslan³

2020

Clin. Exp. Obstet. Gynecol.

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Introduction: Absence of the ductus venosus (ADV) is a rare vascular anomaly often associated with fetal cardiac/extracardiac anomalies, aneuploidies, and hydrops. This study assesses the abnormal venous circulation, associated malformations, and chromosomal anomalies of ADV. Materials and Methods: The authors performed a retrospective study of 14 cases with ADV diagnosed by the prenatal ultrasound in tertiary referral center from 2009 to 2017. Results: The authors detected 14 patients of ADV. Karyotyping was offered to all cases, and four patients accepted the procedure. Normal karyotype was found in three out of four cases, while one case had 45,X0. Five cases underwent termination of pregnancy, six cases died at neonatal period due to accompanying cardiac anomalies, and heart failure. Three cases survived (the oldest baby is 4-years-old now). Umbilical vein (UV) was connected to portal venous system (PVS) in two cases (intrahepatic drainage, one of them is surviving), while UV was connected to systemic venous circulation in 12 cases (extrahepatic drainage, two of them are surviving). In five cases there was no other reason that might explain cardiomegaly and hydrops except ADV (two of them is surviving). Three cases were diagnosed as cystic hygroma in first trimester additionally found ADV. All of surviving fetuses delivered after 35 th weeks of gestation. Conclusion: The presence fetal hydrops, accompanying congenital anomalies, and prematurity are associated with poor prognosis in fetuses with ADV. In isolated cases, the prognosis is generally good.

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Section: Discussionmentioning

confidence: 51%

Prenatal diagnosis of ductus venosus agenesis: a retrospective study of associated cytogenetic/congenital anomalies

Özsürmeli¹,

Sucu²,

Arslan³

2020

Clin. Exp. Obstet. Gynecol.

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“…15 There is a paucity of data regarding ADV and its clinical implications. 16 In normal fetal circulation, the DV connects the umbilical vein with the left portal system and the left hepatic vein. 15,16 Oxygenated blood enters the umbilical vein, flows into the DV, bypasses 20%-30% of liver sinusoids, and flows into the IVC so that more oxygenated blood can flow into systemic circulation.…”

Section: Discussionmentioning

confidence: 99%

“…15 There are three main patterns of abnormal connection of the intra-abdominal umbilical vein in ADV: (1) the umbilical vein bypasses the liver and drains directly into the right atrium (46%), (2) the umbilical vein bypasses the liver and drains directly into an iliac or renal vein (25%), or (3) the umbilical vein connects directly to portal circulation without giving rise to DV (21%). 15,16 The third combination is the most favorable, while the other two are associated with fetal cardiac failure. 15 Differential diagnoses for HLHS often include other left-sided obstructive lesions that are also considered ductal-dependent after birth, such as aortic coarctation, critical aortic stenosis, and interrupted aortic arch.…”

Section: Discussionmentioning

confidence: 99%

First-Trimester Diagnosis of Hypoplastic Left Heart Syndrome: A Case Report

2021

Journal of Diagnostic Medical Sonography

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Hypoplastic left heart syndrome (HLHS) comprises a spectrum of left-sided heart anomalies resulting from left outflow or inflow obstruction. Obstruction most often occurs at the levels of the aortic valve and/or mitral valve due to stenosis or atresia. HLHS is a lethal cardiac anomaly if not treated within the first week of life. Knowledge of sonographic features could aid in early detection, which results in better planning and management of pregnancy. This report presents a case in which HLHS was discovered during a routine dating and viability sonogram, performed at 12 weeks’ gestation.

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“…The umbilical vein can also bypass the liver and connect to the inferior vena cava by one iliac or renal vein (26%), causing hyperperfusion of the liver sinusoids and portal hypertension and hydrops. Lastly, the umbilical vein may connect to the portal circulation without giving rise to the DV (21%) [ 83 , 84 ]. Therefore, when ADV is detected, a more detailed fetal examination and the detection of other anomalies is often necessary.…”

Section: Ductus Venosusmentioning

confidence: 99%

Clinical Significance of Ductus Venosus Waveform as Generated by Pressure- volume Changes in the Fetal Heart

Braga

Moleiro

Guedes-Martins

2019

CCR

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The ductus venosus is a vascular shunt situated within the fetal liver parenchyma, connecting the umbilical vein to the inferior vena cava. This vessel acts as a bypass of the liver microcirculation and plays a critical role in the fetal circulation. The ductus venosus allows oxygenated and nutrient-rich venous blood to flow from the placenta to the myocardium and brain. Increased impedance to flow in the fetal ductus venosus is associated with fetal aneuploidies, cardiac defects and other adverse pregnancy outcomes. This review serves to improve our understanding of the mechanisms that regulate the blood flow redistribution between the fetal liver circulation and fetal heart and the clinical significance of the ductus venosus waveform as generated by pressure-volume changes in the fetal heart.

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Absent ductus venosus: case series from two tertiary centres

Abstract: Absence of the ductus venosus may be compatible with normal fetal development without relevant disturbance of circulation and oxygenation independently from type of abnormal venous circulation.

Cited by 14 publications

References 35 publications

Prenatal diagnosis of ductus venosus agenesis: a retrospective study of associated cytogenetic/congenital anomalies

Prenatal diagnosis of ductus venosus agenesis: a retrospective study of associated cytogenetic/congenital anomalies

First-Trimester Diagnosis of Hypoplastic Left Heart Syndrome: A Case Report

Clinical Significance of Ductus Venosus Waveform as Generated by Pressure- volume Changes in the Fetal Heart

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