Absent Ductus Venosus With Single Umbilical Artery: A Rare Association

Abstract

Absent ductus venosus is a rare anomalous venous connection in fetus where the fetal outcome depends on type of venous connection and associated anomalies. Poor outcome is reported where the umbilical vein directly drains in to Rt atrium bypassing liver. Better resolution of ultrasound with Color Doppler makes possible to detect the anomaly early. Here we are presenting a case of antenataly diagnosed absent ductus venous with umbilical vein directly draining in to Rt atrium bypassing liver. Case was diagnosed by Ultrasonography with color Doppler and MRI study. INTRODUCTION:Normally in fetal circulation Oxygen-rich blood is carried by the umbilical vein from the placenta to the fetus. The umbilical vein enters at the umbilicus and gives two branches: right umbilical vein passing to the right side of the liver, is joined by the portal vein, and finally drains into the inferior vena cava (IVC) via the hepatic veins. The left umbilical vein gets shunted via the ductus venosus into the IVC bypassing the hepatic circulation and shunting the oxygenated blood primarily to fetal brain and myocardium. Due to such a critical role ductus venosus has an upper hand in conjunction to other fetal shunts. Here we present a case of absent ductus venosus with single umbilical artery and other associated anomalies which was diagnosed during routine ultrasound examination and subsequently examined by 3 Tesla MRI.

Study of cardiovascular anomalies in perinatal autopsies

“…ADV itself is significantly associated with fetal cardiac and extracardiac anomalies, aneuploidies and hydrops, independent of the type of umbilical venous drainage. 8,9 Hypoplastic left heart syndrome (HLHS) is a complex combination of cardiac malformations that probably results from multiple developmental errors in the early stages of cardiogenesis and that, if left untreated, invariably proves fatal. 10 Cantrell's pentalogy (CP), a rare congenital malformation, consists of the supraumbilical abdominal wall defect, the sterna lower part defect and agenesis of the anterior portion of the diaphragm, an absence of the diaphragmatic part of the pericardium, and a malformation of cardia.…”