Prenatal ultrasonographic characteristics and prognosis of fetal umbilical-portal-systemic venous shunt: analysis of 14 cases
10.3760/cma.j.cn113903-20211106-00927
- VernacularTitle:胎儿脐-门-体静脉分流的产前超声特征及预后：14例分析
- Author:
Cheng CHEN
1
;
Xiaohang ZHANG
;
Hongmei DONG
;
Suzhen RAN
Author Information
1. 重庆市妇幼保健院超声科，重庆 401120
- Keywords:
Abnormalities, multiple;
Umbilical veins;
Portal vein;
Portal system;
Ultrasonography, prenatal
- From:
Chinese Journal of Perinatal Medicine
2022;25(5):349-354
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the prenatal ultrasonographic features and prognosis of fetal umbilical-portal-systemic venous shunt (UPSVS).Methods:This retrospective study retrieved the records of 14 fetuses with UPSVS from Chongqing Health Center for Women and Children from January 2018 to September 2020, to describe their ultrasonographic features, concomitant malformations, chromosomal examination results, and follow-up.Results:All the 14 cases were classified into three types: Type Ⅰ ( n=2), the umbilical vein directly connected to the systemic venous detouring around the liver; Type Ⅱ ( n=2), the umbilical vein connected to the distal inferior vena cava instead of the left atrium after entering the liver through the ductus venosus; and Type Ⅲa ( n=10), those with an intrahepatic shunt, between the intrahepatic portal venous system and the hepatic vein. Of the 14 fetuses, 11 had normal chromosome test results, including four had serum screening of Down syndrome in the first trimester, four had non-invasive prenatal testing, and three had prenatal genetic diagnosis. Six cases were complicated by other system malformations. Fetal growth restriction and heart failure were found in four cases each. Four pregnancies were terminated due to other anomalies and the other 10 ended in live births with good prognosis for the fetuses. Conclusions:Special attention should be paid to the fetal umbilical- portal-venous system when there are unexplained fetal growth restriction, fetal heart failure, or abnormal blood vessels in the abdominal section of the fetus. UPSVS has typically ultrasonographic features, which can prenatally determine the shunt type and the integrity of the intrahepatic portal venous system. A full assessment of the intrauterine fetal condition and other malformations are of great value in prognostic counseling.
