The Turkish Journal of Pediatrics
2020 , Vol 62 , Num 2
Persistence of right umbilical vein: a singular case
1 Departments of Pediatrics, Fondazione Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore Largo Francesco Vito 1, 00168 Rome, Italy2 Departments of Obstetrics, Gynaecology, Fondazione Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy DOI : 10.24953/turkjped.2020.02.024 Background. Persistent right umbilical vein (PRUV) is one of the most common prenatally detected venous anomaly. In the intrahepatic variant (I-PRUV) the right umbilical vein fuses with right portal vein and through the ductus venous drains into inferior vena cava, while in the uncommon extrahepatic variant (E-PRUV), the vein bypasses the liver completely. E-PRUV has a worse prognosis compared to I-PRUV, due either to severe hemodynamic effects or to the frequent association with other severe fetal malformations.
Case. Here we report a case of E-PRUV with good outcome. Prenatal fetal ultrasonography (US) performed at 33 weeks of gestation in 28-year old woman, highlights the presence of E-PRUV with right UV draining in inferior vena cava. In the male neonate born at 35 weeks of gestation by C-section, the Apgar Score was 95`- 1010 and no other associated malformations and hemodynamic decompensation were found. Postnatal abdominal US showed the presence of enlarged paraumbilical veins.
Conclusions. The association of E-PRUV draining into the inferior vena cava with shunt through paraumbilical veins, could have preserved offspring by severe cardiac overload, positively affecting prognosis.
Keywords : persistent right umbilical vein, fetus, neonate