Ductus venosus agenesis and fetal malformations: what can we expect? - a systematic review of the literature

J Perinat Med. 2018 Dec 19;47(1):1-11. doi: 10.1515/jpm-2018-0163.

Abstract

Background The ductus venosus agenesis (DVA) is a rare condition with a variable prognosis that relies partly on the presence of associated conditions. The purpose of our study was to analyze the literature regarding the post-natal outcome of fetuses with DVA associated with fetal malformations, in order to discuss the best management options for couples. Methods We performed a systematic review of the literature of MEDLINE and SCOPUS electronic databases in a 25-year period from 1992 to September 2017. Methods We found 340 cases of DVA associated with fetal abnormalities. The most common chromosomal abnormalities were: monosomy X (12/48, 25%), trisomy 21 (11/48, 22.9%) and trisomy 18 (6/48, 12.5%). From the 340 cases with DVA, in 31 cases the umbilical venous shunt type was not reported. Of the fetuses, 60.8% (188/309) had an extrahepatic umbilical venous drainage while 39.2% (121/309) presented an intrahepatic connection. The DVA was associated in 71 cases (23.0%) with cardiac abnormalities, in 82 cases (26.5%) with extracardiac abnormalities and in 85 cases (27.5%) with both cardiac and extracardiac abnormalities. Conclusion DVA associated with both cardiac and extracardiac malformations may confer a poorer fetal outcome, a clinically relevant fact that should clarify what can be expected from this entity and help prenatal counseling.

Keywords: agenesis; ductus venosus; fetal malformations; outcome.

Publication types

  • Systematic Review

MeSH terms

  • Abnormalities, Multiple / diagnosis*
  • Female
  • Fetus* / blood supply
  • Fetus* / diagnostic imaging
  • Heart Defects, Congenital / diagnosis*
  • Humans
  • Infant, Newborn
  • Male
  • Pregnancy
  • Pregnancy Outcome
  • Ultrasonography, Prenatal / methods
  • Umbilical Veins / abnormalities*
  • Veins / abnormalities*