F58Anatomical variation of the fetal venous system

Abstract

ObjectiveThis report presents our experience in the prenatal diagnosis of anomalies of fetal veins using high‐resolution and color Doppler ultrasound.DesignIn an observatorial study 15 cases of abnormalities of the umbilical, portal, hepatic and caval venous system have been diagnosed at our division over the past 5 years. The abnormality, the underlying embryologic disorder and the outcome of the pregnancy are presented.ResultsIn group A, 8 fetuses had an abnormal course of the umbilical vein with a patent (n = 3) or absent (n = 5) ductus venosus. No portal veins and absent or abnormal hepatic veins were visualized. Six fetuses (75%) did not have an associated malformation and have survived. Two pregnancies were terminated or ended in fetal demise. In group B, 7 fetuses with an abnormal caval system had a left (n = 5) and right (n = 2) atrial isomerism with a cardiac defect in 6 cases (86%). The pregnancies ended in 4 terminations of pregnancy and two infant deaths. Only an infant with a left atrial isomerism and a normal heart has survived.ConclusionIn a targeted fetal scan the course of the venous system should be carefully examined using color Doppler. Any suspicious finding should be followed by a detailed assessment of the specifity of this abnormality considering the embryological development as well as the associated malformations.