A retrospective single centre review of the incidence and prognostic significance of persistent foetal right umbilical vein

Kumar, S.; Chandra, Vikash; Balakrishnan, Bijoy; Batra, Manav; Kuriakose, Rekha; Kannoly, Gopinathan

doi:10.1080/01443615.2016.1196171

Cited by 9 publications

(6 citation statements)

References 30 publications

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“…The fetal incidence of both intrahepatic and extrahepatic RUV is around 0.2%; however, as our fetal cardiovascular evaluation population consists of those with maternal and fetal risk factors, we noted a higher incidence at 0.5%. In about 25% of cases, an RUV may be associated with either minor or major abnormalities of the cardiovascular, genitourinary, gastrointestinal and skeletal systems, chromosomal and nonchromosomal syndromes, and situs abnormalities . About 5%, 7% in our series, of RUV are extrahepatic, and these are more frequently associated with other anomalies and at risk for hemodynamic problems from absence of the ductus venosus .…”

Section: Discussionmentioning

confidence: 68%

“…In about 25% of cases, an RUV may be associated with either minor or major abnormalities of the cardiovascular, genitourinary, gastrointestinal and skeletal systems, chromosomal and nonchromosomal syndromes, and situs abnormalities . About 5%, 7% in our series, of RUV are extrahepatic, and these are more frequently associated with other anomalies and at risk for hemodynamic problems from absence of the ductus venosus . The majority of intrahepatic RUV cases are isolated finding and associated with excellent prognosis .…”

Section: Discussionmentioning

confidence: 70%

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Persistent right umbilical vein in isomerism

Acherman

Evans

2019

Prenatal Diagnosis

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Objective Our objective was to evaluate the incidence of a persistent right umbilical vein in isomerism versus situs solitus. Methods For this retrospective, observational, nonrandomized report, we identified fetuses with confirmed right umbilical veins from all patients referred for fetal echocardiography in Southern Nevada between January 2006 and January 2019. Results For the period January 2006 to January 2019, we identified 89 fetuses with situs solitus and a right umbilical vein from 16 320 women undergoing prenatal cardiac evaluation, resulting in a right umbilical vein incidence of 0.5% in situs solitus. For the same period, we identified 36 fetuses with isomerism and confirmatory umbilical vein imaging. Of the 36, 15 (42%) had right umbilical veins. Of the 15, four of 11 (19%) had left isomerism, and 11 of 15 (73%) had right isomerism (P = .006). Conclusions A right umbilical vein is rare with situs solitus and common with isomerism. A right umbilical vein is more common in right isomerism than left isomerism and should alert the clinician to check for isomeric situs, especially right isomerism.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 70%

Persistent right umbilical vein in isomerism

Acherman

Evans

2019

Prenatal Diagnosis

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“…The presence of a persistent right umbilical vein is rare, occurring in just 1 out of 889 births or 0.11%, according to a study by Kumar et al 38 Most cases (91.3%) showed intrahepatic drainage, with only 8.7% exhibiting extrahepatic drainage. A persistent right umbilical vein can sometimes be associated with severe congenital anomalies.…”

Section: Discussionmentioning

confidence: 99%

Absence of Ductus Venosus: A Comparison of 2 Distinctive Fetal Autopsy Cases and Embryologic Perspectives

Chan,

Suchet,

et al. 2023

Pediatr Dev Pathol

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In fetal circulation, oxygenated blood from the placenta flows through the umbilical vein into the ductus venosus (DV), then enters the inferior vena cava, and subsequently reaches the right atrium of the heart. The DV serves as a shunt, allowing this oxygen-rich blood to bypass the liver. The absence of the DV (ADV), also known as agenesis of the DV, is a rare congenital anomaly. Without a DV, blood from the umbilical vein must follow alternative routes to the heart. In ADV cases, blood from the umbilical vein must follow 1 of 2 primary drainage patterns: either an extrahepatic shunt or an intrahepatic shunt. This report details the antenatal ultrasound and postmortem findings of 2 fetuses diagnosed with ADV by prenatal imaging studies. The first case involved a fetus with a persistent right umbilical vein connected directly to the suprahepatic IVC, accompanied by early obliteration of the left umbilical vein and true agenesis of the DV. This fetus also had additional congenital anomalies. In contrast, the second case involved a fetus with a normal left umbilical vein that entered the liver. However, despite an ultrasound diagnosis of “absence” of the DV, a DV was present, though markedly hypoplastic and probably minimally functional or non-functional. In this case, blood from the umbilical vein likely followed an alternate intrahepatic route through the portal and hepatic veins, before reaching the heart (intrahepatic shunt). These contrasting cases emphasize the heterogeneity of vascular anomalies and embryologic origins captured by the term “ADV.” Additionally, the terminology of “absence” or “agenesis” may be misleading in some purported ADV cases. Specifically, in the second case, the DV was not absent; it was markedly hypoplastic instead. This also appears to be the first reported case of a hypoplastic DV in a fetus. Both cases underscore the importance of effective collaboration and clear communication between maternal-fetal medicine specialists and pathologists.

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“…In the embryonic development when the cranial segment of the right umbilical vein and the left umbilical vein are obstructed, the caudal segment of the right umbilical vein expands and anastomoses with the right vitelline vein to form a PRUV (permanent right umbilical vein), which will turn into the RRL after birth. The incidence of RRL is 0.2% -1.2% [9], 0.1% -1.2% [10], and PRUV is 0.09% -0.2% [2], 0.2% -1% [11] and 0.08% -0.23% [9]. If all the RRL comes from the PRUV, the incidence of the RRL should be less than or equal to the PRUV.…”

Section: Sato Et Al and Kayoko Et Al Reported The Absence Of The Horizontal Portion Of The Left Branchmentioning

confidence: 99%

Absence of the Horizontal Portion of the Left Portal Vein Diagnosed by Ultrasound and Computed Tomography

Cheng¹,

Liu²,

Zhu³

et al. 2021

Advanced Ultrasound in Diagnosis and Therapy

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The absence of the horizontal portion of the left portal vein is rare, and it is often not diagnosed by ultrasound. This article reports a case where ultrasound identified a structural anomaly between the gallbladder and the round ligament of the liver, and then computed tomography confirmed the absence of the horizontal portion of the left portal vein. We proposed the possible etiologies from an embryonic development perspective, and described the questions to be further investigated after a literature review.

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A retrospective single centre review of the incidence and prognostic significance of persistent foetal right umbilical vein

Cited by 9 publications

References 30 publications

Persistent right umbilical vein in isomerism

Persistent right umbilical vein in isomerism

Absence of Ductus Venosus: A Comparison of 2 Distinctive Fetal Autopsy Cases and Embryologic Perspectives

Absence of the Horizontal Portion of the Left Portal Vein Diagnosed by Ultrasound and Computed Tomography

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