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Fetal umbilical-systemic shunt with a positive issue.

Julie Dauvillée¹, Ingrid Ingargiola², Mathieu Jouret²

¹Université Catholique de Louvain, Service de Gynécologie et d'Obstétrique, Centre Hospitalier de Wallonie Picarde, Rue des Sports 51, 7500 Tournai, Belgium.

Journal of Gynecology Obstetrics and Human Reproduction

|November 25, 2019

Summary

This case study highlights a rare umbilical-systemic shunt diagnosed via antenatal ultrasound. Despite a poor initial prognosis, the infant showed good clinical and ultrasound outcomes after treatment for pulmonary arterial hypertension.

Keywords:

Agenesis ductus venosus Fetal umbilical-portal-systemic venous shunts Postnatal outcome

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Area of Science:

Perinatology
Fetal Medicine
Neonatology

Background:

Abnormal umbilical venous return presents diagnostic challenges.
Umbilical-systemic shunts are rare fetal vascular anomalies.
Antenatal diagnosis is crucial for timely intervention.

Observation:

A case of Type 1 umbilical-systemic shunt was diagnosed antenatally.
Associated anomalies included cardiomegaly, IUGR, oligohydramnios, and left-lobe hypoplasia.
Agenesis of the intrahepatic umbilical vein, left portal vein, and ductus venosus were noted.

Findings:

The combination of anomalies suggested a poor prognosis (11.1% survival).
Pulmonary arterial hypertension developed at birth but was successfully treated.
The infant demonstrated a good clinical and ultrasound evolution post-treatment.

Implications:

Antenatal ultrasound is vital for diagnosing complex umbilical venous return abnormalities.
Early diagnosis and prompt management can improve outcomes in neonates with severe fetal conditions.
This case underscores the importance of vigilant postnatal care for infants with congenital vascular anomalies.