Abstract
The present study aimed at identification of fetuses with absent ductus venosus at
prenatal screening ultrasound, determination of the type of umbilical venous drainage,
and follow-up to assess their outcomes. This prospective study was conducted at CIMAR
Hospital, Kerala, in antenatal women with singleton pregnancy, who underwent screening
at 11 to 13 + 6 weeks, from November 2013 to January 2015. Ultrasonography was done
according to Fetal Medicine Foundation (FMF) protocol. Absence of ductus venosus was
diagnosed, when ductus venosus was not visualized connecting the portal sinus to the
subphrenic confluence. The type of umbilical venous drainage was determined. Karyotyping
was offered in all diagnosed cases and follow-up was obtained. Absent ductus venosus
was diagnosed in three out of the 3691 women screened. Two of these had intrahepatic
and the third had extrahepatic type of umbilical venous drainage. Karyotype was normal
in all the three. The first patient with intrahepatic type of drainage developed polyhydramnios
and ended up in intrauterine fetal demise at 26 weeks of gestation. In the second
patient, malaligned ventricular septal defect and intestinal obstruction was detected
in the anomaly scan. She underwent termination of pregnancy. The fetus with extrahepatic
type of umbilical venous drainage developed cardiomegaly on follow-up. This baby underwent
ligation of patent ductus arteriosus at third month of life. Our study suggests that
absence of ductus venosus is associated with variable fetal outcome. Careful search
of co-existing anomalies and follow-up is warranted in these cases.
Keywords
Absent ductus venosus - Umbilical venous drainage - Cardiomegaly - Polyhydramnios
- Intrauterine death
