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The human fetal venous system: normal embryologic, anatomic, and physiologic characteristics and developmental
Sozos J Fasouliotis1, Reuven Achiron, Zvi Kivilevitch
1Department of Obstetrics and Gynecology, Hadassah University Hospital, Ein Kerem, Jerusalem, Israel.
Summary
High-resolution ultrasonography advances fetal venous system evaluation. This study details normal development and anomalies, aiding in prenatal diagnosis and understanding of fetal circulation issues.
Area of Science:
- Medical imaging
- Fetal medicine
- Embryology
Background:
- High-resolution ultrasonography and color-coded Doppler imaging have revolutionized fetal venous system evaluation.
- These technologies enhance understanding of normal fetal venous circulation and abnormal conditions.
Purpose of the Study:
- To describe normal anatomic development of the human fetal venous system.
- To outline the complex anomalies of the human fetal venous system.
- To review recent literature on prenatal diagnosis of these anomalies.
Main Methods:
- Description of normal embryologic and anatomic development.
- Literature search of MEDLINE for recent series on prenatal diagnosis of fetal venous anomalies and associated malformations.
Main Results:
- Fetal venous system anomalies occur sporadically and are often linked to cardiac or other malformations.
- Pathophysiologic mechanisms for abnormal in utero venous development are largely undetermined.
- A classification system into 4 major groups based on vein type, embryologic precursor, and etiology is presented.
Conclusions:
- Prenatal evaluation for venous anomalies requires a thorough cardiac assessment, including pulmonary venous drainage.
- Detailed anatomic surveys of umbilical, portal, hepatic, and ductal systems are crucial.
- Identifying aberrant communication may provide clues to systemic diseases or thromboembolic phenomena.