In-utero evaluation of the fetal umbilical–portal venous system among fetuses with persistent right umbilical vein: Two-and three-dimensional ultrasonographic study

Abeer Massarwa*, Tal Weissbach, Efrat Hadi, Vered YuLzari, Baruch Messing, Laura Adamo, Tal Elkan-Miller, Reuven Achiron, Zvi Kivilevich, Yossi Bart, Boaz Weisz, Rakefet Yoeli-Ullman, Shali Mazaki, Eran Kassif

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The aim of this study was to describe the anatomy of the portal system in fetuses with persistent right umbilical vein (PRUV). Methods: Prospective observational study of fetuses diagnosed with PRUV. All patients underwent a comprehensive portal system anatomy scan supplemented by two-dimensional (2D) and three-dimensional (3D) color doppler modalities. Results: 29 fetuses with PRUV were studied. We perceived an identical anatomical pattern in 28 fetuses. The right umbilical vein drains to the portal sinus (future right portal vein, RPV), which has a configuration of a left portal vein (LPV) in the normal left portal system, with three emerging branches: inferior (RPVi), medial (RPVm) and superior (RPVs). The RPV then courses to the left, towards the stomach to the point of the bifurcation of the main portal vein (MPV) to become the left portal vein. The LPV has an RPV configuration in a normal portal system with anterior (LPVa) and posterior (RPVp) branches. This anatomical layout mimics a mirror image of the normal anatomy of left portal system. Conclusion: PRUV has unique umbilical portal venous anatomy, which is a mirror image of the normal left portal system. It can be demonstrated prenatally and serve as an additional tool for prenatal diagnosis of PRUV.

Original languageEnglish
Pages (from-to)68-76
Number of pages9
JournalPrenatal Diagnosis
Volume44
Issue number1
DOIs
StatePublished - Jan 2024

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