Prenatal Diagnosis of Ductus Venosus Agenesis: Case Series

Yıl 2022, , 100 - 104, 30.06.2022

Neval Çayönü Kahraman , Ozge Yucel Celik , Cantekin İskender

https://doi.org/10.46969/EZH.1110736

Öz

Objective: To evaluate the clinical significance of ductus venosus agenesis
Material and method: Ductus venosus agenesis (DVA) cases registered to our hospital between January 2021 and September 2021 were retrospectively analysed. Ultrasound findings, prenatal features and postnatal findings were noted.
Results: During the study period 4 cases with DVA were detected. According to the study, the incidence of DVA was 2.6/10000. Two of the cases were of the intrahepatic type and the other two were of the extrahepatic type of DVA. Genetic test of case 3 and 4 were reported as normal, but genetic test of case 1 and 2 could not be determined because they rejected invasive prenatal testing. On prenatal ultrasonography, there was increased nuchal thickness in case 2 and 3. Hydrops was present in cases 2 and 4 and intrauterine death occured during prenatal folluow up. Because of severe preeclampsia, placental abruption and fetal disstres were detected in case 1, caserean section was performed at 27 weeks 3 days, and neonatal death occurred one week after birth. Pregnancy of case 3 reached term, but pregnant woman was not followed up in our hospital.
Conclusion: The rate of structural abnormality was increased in cases with DVA. Therefore, a detailed prenatal ultrasonography should be perfomed in any case when DVA detected. The long term results are not clearly known. Ductus venosus should be considered in the assessment of fetal anatomy along with the examination of nuchal thickness begining of the first trimester.

Anahtar Kelimeler

Ductus venosus agenesis, intrahepatic drainage, extrahepatic drainage, umblical vein, portal system

Duktus Venozus Agenezisinin Prenatal Tanısı: Olgu Serisi

Öz

Amaç: Duktus venozus agenezisinin klinik önemini değerlendirmek
Gereç ve Yöntem: Ocak 2020 ve Eylül 2021 tarihleri arasında hastanemizde duktus venosuz agenezisi (DVA) tanısı konulan hastaların kayıtları retrospektif olarak incelendi. DVA olgularının ultrason bulguları, antenatal özellikleri ve postnatal sonuçları değerlendirildi.
Bulgular: Çalışma süresi içinde 4 olgu DVA tanısı konulmuş olup, DVA insidansı 2,6/10000 olarak saptandı. Olguların ikisi intrahepatik tip, diğer ikisi ekstrahepatik tip DVA idi. İnvaziv testi kabul eden 3 ve 4 nolu olguların karyotipi normal olarak rapor edildi, 1 ve 2 nolu olgu ise invaziv testi reddetti. Hastaların prenatal ultrasonografisinde 2 ve 3 no lu olgularda artmış ense kalınlığı mevcuttu. 2 ve 4 numaralı olgularda hidrops fetalis saptandı ve bu olgular prenatal takipte intrauterin ex oldu. Olgu 1 ise 27 hafta 3 gün iken şiddetli preekalmpsi, plasental dekolman, fetal stres tanılarıyla acil sezeryan oldu ve doğumdan bir hafta sonra neonatal ölüm gerçekleşti. Olgu 3’ün gebeliği miada kadar ulaşmış, fakat gebe hastane takibimizden çıkmıştı.
Sonuç: DVA saptanan olgularda fetal anomali sıklığı artmıştır. Bu yüzden bu hastalara detaylı bir antenatal ultrasonografi yapılmalıdır. Duktus venozus, birinci trimesterden itibaren ense kalınlığı muayenesi ile birlikte fetal anatomiyi değerlendirilirken bakılması gereken bir oluşumdur.

Anahtar Kelimeler

Duktus venozus agenezisi, intrahepatik drenaj, ekstrahepatik drenaj, umblikal ven, portal sistem

Kaynakça

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