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Absent ductus venosus: case series from two tertiary centres
Giuseppe Maria Maruotti1, Gabriele Saccone1,2, Andrea Ciardulli3
1a Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine , University of Naples "Federico II" , Naples , Italy.
Insights
Congenital absence of the ductus venosus (ADV) is a rare condition. However, ADV can be compatible with normal fetal development and survival, even with abnormal venous circulation patterns.
Area of Science:
- Perinatology
- Vascular Malformations
- Fetal Cardiology
Background:
- Congenital absence of the ductus venosus (ADV) is a rare vascular anomaly.
- ADV is frequently associated with fetal cardiac and extracardiac anomalies, aneuploidies, and hydrops.
- Prognosis is influenced by venous circulation patterns, associated malformations, and chromosomal aberrations.
Purpose of the Study:
- To audit outcomes of prenatally diagnosed cases of absence of the ductus venosus.
- To analyze the relationship between ADV, associated anomalies, and fetal outcomes.
Main Methods:
- Retrospective audit of consecutive cases with prenatally diagnosed ADV.
- Analysis of gestational age at diagnosis, karyotyping results, and survival rates.
Main Results:
- Six cases of prenatally diagnosed ADV were identified, with diagnosis ranging from 15 to 35 weeks gestation.
- Five out of six cases had normal karyotypes.
- Four neonates survived 28 days; two neonates with extrahepatic ADV died within 48 hours of delivery.
Conclusions:
- Absence of the ductus venosus can be compatible with normal fetal development.
- Normal circulation and oxygenation may be maintained despite ADV, irrespective of the venous circulation pattern.
- Favorable outcomes are possible even with complex vascular anomalies.
Introduction:
Congenital absence of the ductus venosus (ADV) is a rare vascular anomaly often associated with fetal cardiac and extracardiac anomalies, aneuploidies, and hydrops. The prognosis depends on the patterns of abnormal venous circulation, on the associated malformations and on chromosomal aberrations.
Methods:
We performed a retrospective audit of all consecutive cases with ADV referred in our centres and analysed the outcomes.
Results:
A total of six cases with prenatally diagnosed ADV were identified. The gestational age at diagnosis ranged from 15 to 35 weeks. Karyotyping was performed in all cases. Normal karyotype was found in five out of the six cases. Overall, four neonates survived at 28 days follow-up. The other two died 48 h after delivery: both of them had extrahepatic ADV.
Discussion:
Absence of the ductus venosus may be compatible with normal fetal development without relevant disturbance of circulation and oxygenation independently from type of abnormal venous circulation.
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