Ductus venosus agenesis with infrahepatic umbilical connection

Hitanshu Bhatt, MD, Gouri Nagraj Bhatt, MD

Consultant Fetal Maternal medicine, Surat, India

Case report

A 35 year-old woman (G3P2L1), was sent to our unit at 20 weeks 4 days of pregnancy. She had a previous termination of pregnancy due to hypoplastic cardiac etiology. During the current pregnancy, an amniocentesis was done for positive dual marker screening for aneuploidy, and revealed normal karyotype.

We found mild fetal growth restriction (AC – 9th centiles, FL- 10th centiles), single umbilical artery, small inlet ventricular septal defect, absent ductus venosus and absent portal venous system with persistence of right umbilical vein opening directly into IVC (Type III DV agenesis).

Images 1 and 2: 2D and Doppler images of the fetal abdomen showing persistence of the right umbilical vein.

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Images 3 and 4: Sagittal views with color Doppler showing the right umbilical vein draining into IVC and absence of the DV.

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Images 5 and 6: 3D color Doppler rendering showing a normal reference and our case, with absence of the DV and venous flow with spectral Doppler.

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Images 7 and 8: color Doppler images of the single umbilical artery and small VSD.

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Video 1: color rendering revealed UV draining into IVC.

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