Prenatal ultrasonographic diagnosis of the fetal ductus venosus abnormalities

Abstract

Objective To explore the prenatal ultrasound image features and clinical significance of fetal ductus venosus abormalities. Methods Fifteen fetuses with ductus venosus abormalities diagnosed by prenatal ultrasonography at Peking University Third Hospital were retrospective review. The prenatal findings, umbilical shunting type, perinatal outcomes, and autopsy reports were analyzed. Results Fourteen fetuses were found with absence of ductus venosus. In 6 fetuses the umbilical vein connected to the portal vein, 5 fetuses the umbilical vein connected to the inferior vena cava and 3 fetuses the umbilical vein connected to the right atrium. The remaining 1 fetus was found obliteration of ductus venosus. Absence of ductus venous showed no normal ductus venous and the umbilical vein almost always drained directly into portal vein, inferior vena cava or right atrium. Obliteration of ductus venous showed normal ductus venous was replaced by a tiny echogenic string without blood flow. Three cases had intracardiac and extracardiac abnormalities; 4 cases had extracardiac abnormalities only; 8 of these, ductus venosus abormality were isolated. Two cases had trisomy 21 syndrome. Four patients underwent legal termination of pregnancy; 2 were intrauterine fetal death; and 8 carried to term wit normal outcome; the remaining one underwent operation due to extracardiac abnormality and postoperative course was uneventful. Conclusions Prenatal ultrasound can be used to diagnose fetal ductus venosus abormalities. Hemodynamic depends on umbilical venous drainage site and diameter. The prognosis for this group of anomalies depends on the chromosomal abnormalities and additional findings. Chromosome and ultrasonic monitoring are suggested for following pregnancy. Key words: Ultrasonography; Fetus; Absence of ductus venosus; Obliteration of ductus venosus