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Published on: December 16, 2022
Two ductus venosus: a previously unreported anomaly
Mohammed Firdouse1, Arnav Agarwal2, Bharadwaj Pindiprolu3
1Faculty of Health Sciences, McMaster University, Hamilton, ON Canada ; McMaster University, 4077 Tea Garden Circle, Mississauga, ON L5B 2W5 Canada.
This is the first reported case of a fetus with two ductus venosus (DV). This rare finding highlights the importance of monitoring umbilical vein connections for fetal well-being.
Area of Science:
- Fetal Medicine
- Vascular Anatomy
- Perinatal Cardiology
Background:
- The ductus venosus (DV) is crucial for fetal circulation, connecting the umbilical vein to the inferior vena cava (IVC).
- Abnormalities in DV formation can impact fetal development and outcomes.
- A four-vessel cord and dilated bowel were noted in the presented case.
Purpose of the Study:
- To report the first documented case of a fetus with two ductus venosus.
- To discuss the implications of supernumerary umbilical veins and DV connections on fetal circulation.
- To emphasize the need for vigilant monitoring in cases of atypical umbilical venous anatomy.
Main Methods:
- Detailed ultrasonography and echocardiography were performed at 31 weeks of gestation.
- Doppler patterns of the two DVs were analyzed.
- Postnatal assessment confirmed uneventful delivery and stable hemodynamics.
Main Results:
- A fetus with a persistent right umbilical vein and two distinct ductus venosus (DV) anomalies was identified.
- Both DVs were visualized anastomosing with the inferior vena cava (IVC).
- The infant was delivered healthy with stable hemodynamics.
Conclusions:
- The presence of multiple umbilical veins necessitates corresponding ductus venosus connections for balanced fetal circulation.
- A mismatch between supernumerary umbilical veins and DV connections may predispose fetuses to hydrops fetalis and adverse perinatal outcomes.
- Feto-maternal specialists must provide close monitoring for fetuses with atypical umbilical venous anatomy due to associated risks.
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