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Updated: Mar 31, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Hemodynamic studies of isolated absent ductus venosus
Phudit Jatavan1, Walairat Kemthong1, Chitrakan Charoenboon1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand.
Insights
Isolated absent ductus venosus (IADV) in fetuses can lead to serious complications. Hemodynamic assessment during pregnancy helps predict fetal hydrops and mortality, especially with extra-hepatic umbilical vein drainage.
Area of Science:
- Fetal Medicine
- Cardiology
- Medical Imaging
Background:
- Isolated absent ductus venosus (IADV) is a rare congenital anomaly.
- Prenatal diagnosis and understanding of its hemodynamic impact are crucial.
Purpose of the Study:
- To evaluate hemodynamic changes in fetuses with isolated absent ductus venosus (IADV).
- To identify hemodynamic predictors of adverse outcomes in IADV.
Main Methods:
- Prenatal ultrasonography for IADV diagnosis.
- Fetal hemodynamic assessment including cardiac dimensions, function, and venous flow patterns.
- Evaluation of inferior vena cava preload index and umbilical vein pulsations.
Main Results:
- Six fetuses with extra-hepatic UV drainage exhibited elevated preload index, UV pulsations, and cardiomegaly, with 4 developing hydrops and 3 experiencing perinatal mortality.
- Three fetuses with intra-hepatic drainage showed normal hemodynamics and survived.
Conclusions:
- Hemodynamic assessment is vital for predicting hydrops and mortality in fetuses with IADV.
- Poor prognostic factors include cardiac overload, cardiomegaly, poor myocardial performance, increased preload, UV pulsations, and extra-hepatic drainage.
Objective:
The objective of this article is to evaluate hemodynamic changes among fetuses with isolated absent ductus venosus (IADV) diagnosed by prenatal ultrasonography.
Patients And Methods:
Fetuses with prenatal diagnosis of IADV were recruited and followed. Hemodynamic assessment was performed in all cases, including measurement of cardiac dimensions, shortening fraction, myocardial performance index, preload index in the inferior vena cava and the presence of venous pulsations in the umbilical vein (UV).
Results:
Nine fetuses of IADV were assessed, including six cases with extra-hepatic UV drainage and three with intra-hepatic drainage. All fetuses with extra-hepatic UV drainage showed an elevated preload index in the inferior vena cava, venous pulsations in the UV and cardiomegaly. Of them, four had hydrops, two showed poor cardiac function and three resulted in perinatal mortality. Three cases with intra-hepatic drainage had continuous flow in the UV, normal in all hemodynamic parameters and all survived.
Conclusion:
Hemodynamic assessment of fetuses with IADV was helpful in predicting the development of hydrops and perinatal mortality. The poor prognostic factors included cardiac overload, cardiomegaly, poor myocardial performance, increased preload, the presence of venous pulsations and extra-hepatic UV drainage. © 2015 John Wiley & Sons, Ltd.
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