Ductus Venosus Agenesis: A Case Report

Abstract

A 29- year-old primigravida mother with a history of 8 years of infertility and without any history of medical illness spontaneously conceived and delivered a male child whose anomaly scan done at 18 weeks of gestational age was suggestive of a ductus venosus agenesis with intrahepatic shunting of umbilical vein and a tiny echogenic foci in the heart. Further evaluation revealed a negative karyotype of Down’s syndrome, and fluorescence in situ hybridization screening for aneuploidy was also negative, but the mother’s Toxoplasmosis Rubella Cytomegalovirus Herpes Simplex HIV (TORCH) titres were strongly positive for cytomegalovirus IgG. Detailed study did not reveal any morphological or obvious cardiac anomalies or any chromosomal abnormalities; postnatally there were no signs of neonatal hyperbilirubinemia, respiratory distress, or any other signs suggestive of intrauterine infections in the form of hepatosplenomegaly, bleeding manifestations, and jaundice. Hearing and ophthalmic examination were normal. Postnatal echocardiogram revealed a normal functioning heart without any abnormalities. Isolated agenesis of ductus venosus occurs rarely wherein extrahepatic shunting has a bad prognosis because of higher chances of congestive heart failure as the umbilical vein directly drains into the right atrium as compared to the intrahepatic shunting which is reported to have a favorable outcome as seen in our case.