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Absent ductus venosus

Agenesis of the ductus venosus (ADV) is  a rare fetal vascular anomaly. According to the data obtained from the screening tests performed at 11-14 weeks of pregnancy, its incidence is reported to be 1/2500 (12).

Pathology

In the literature review on ductus venosus agenesis, Acherman et.al (13) define five drainage patterns regarding ductuc venosus agenesis under two main topics in the case series. These patterns are;

1. The umbilical vein (UV) connected to the systemic venous circulation by way of the portal sinus:

a. Via an abnormal venous channel from the portal sinus to the  right atrium 

b. Presumably via hepatic sinusoids to the hepatic veins

2. The umbilical vein bypassed the portal sinus and the liver and connected to the systemic venous circulation via an abnormal venous channel:

a. From the umbilical vein to the right atrium directly or through a dilated coronary sinus

  • considered the most common type (5) and carries worst prognosis due to risk of developing congestive cardiac failure (11)

b. From the umbilical vein to the midportion of the inferior vena cava (IVC)

c. From the umbilical vein to the right iliac vein

Associations
Outcome

The prognosis of fetuses with absent DV diagnosed at 11–13 weeks depends on the measurement of NT thickness, being poor if the NT is increased and good if the NT is normal (12)

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