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Abstract
Introduction: congenital intrahepatic portosystemic shunts are abnormal communications between hepatic and portal vessels. We present a case of antenatally diagnosed portohepatic shunt in intrauterine growth restricted (IUGr) fetus with cardiomegaly and transient fetal anemia. case report: A 37-yearold primiparous woman was referred in a late second trimester for fetal growth assessment. Ultrasound revealed IUGr fetus at 9th centile with brain spearing and forward end-diastolic flow in umbilical artery. Middle cerebral artery (McA) peak systolic velocity (PsV) Doppler was high for the gestational age, possibly representing fetal anemia. Fetal liver was enlarged with abnormal circulation consisting of tortuous dilated intrahepatic vessels originating from the umbilical vein and giving off several branches with no clear end point communication sites. Fetal echocardiography showed mild cardiomegaly with hyperdynamic flow state
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