CEUSP. Valencia. Venezuela.

Case report

A 34-year-old patient (G3P2) with non-contributive history was referred to our department at 31st week of gestation. Our examination found age-appropriate fetal biometry. Additionally we noticed ductus venosus agenesis with anomalous drainage of the umbilical vein into iliac vein type 5 (Umbilical cord anomalies © Jeanty www.thefetus.net). The finding was accompanied by marked reduction of flow via intrahepatic vascular network, dilated inferior vena cava, pulsatile umbilical vein flow and opposite direction of flow within two vessels passing along one side of the urinary bladder and dilated iliac veins with three-phase flow.

Image 1, 2: 31 weeks of gestation; transverse scans of the fetal abdomen showing decreased flow via hepatic veins.

Image 3, 4: 31 weeks of gestation; image 3 shows dilated inferior vena cava; image 4 shows pulsed Doppler tracing of the umbilical cord vessels with pulsations within umbilical vein (tracing below baseline) and normal pulsatile flow within umbilical artery (above baseline).

Image 5, and video 1: 31 weeks of gestation; image 5 and video1 demonstrate two vessels with opposite flow passing along one side of the urinary bladder (vessels closer to the probe: umbilical artery and anomalous course of the umbilical vein going down to the pelvis and empting into iliac vein).

Images 6, 7, 8 and video 2: 31 weeks of gestation; the images and video show dilated iliac veins with three-phase flow.