Ultrasonographic classification of 26 cases of fetal umbilical-portal-systemic venous shunts and the correlations with fetal chromosomal abnormalities

Lihua Lu; Limin Yao; Hui Wei; Jilin Hu; Dongmei Li; Yifei Yin; Jie Su; Qian Li; Shu Zhu; Xinhua Tang; Wenming Huang; Baosheng Zhu; Jinman Zhang

doi:10.1186/s12884-023-05525-5

BMC Pregnancy and Childbirth (Apr 2023)

Ultrasonographic classification of 26 cases of fetal umbilical-portal-systemic venous shunts and the correlations with fetal chromosomal abnormalities

Lihua Lu,
Limin Yao,
Hui Wei,
Jilin Hu,
Dongmei Li,
Yifei Yin,
Jie Su,
Qian Li,
Shu Zhu,
Xinhua Tang,
Wenming Huang,
Baosheng Zhu,
Jinman Zhang

Affiliations

Lihua Lu: Faculty of Environmental Science and Engineering, Kunming University of Science and Technology
Limin Yao: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Hui Wei: Department of Medical Ultrasonics, Prenatal Diagnosis Center of Guangxi Zhuang Autonomous Region, Maternity and Child Health-care Hospital of Guangxi Zhuang Autonomous Region
Jilin Hu: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Dongmei Li: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Yifei Yin: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Jie Su: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Qian Li: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Shu Zhu: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Xinhua Tang: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Wenming Huang: National Health Commission Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, Department of Obstetrics and Gynecology, Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province
Baosheng Zhu: Faculty of Environmental Science and Engineering, Kunming University of Science and Technology
Jinman Zhang: Faculty of Environmental Science and Engineering, Kunming University of Science and Technology

DOI: https://doi.org/10.1186/s12884-023-05525-5
Journal volume & issue: Vol. 23, no. 1
pp. 1 – 10

Abstract

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Abstract Objective To investigate the ultrasonographic classification of fetal umbilical-portal-systemic venous shunts (UPSVS) and the correlations with fetal chromosomal abnormalities. Methods We retrospectively analyzed the ultrasound characteristics and the corresponding chromosomal abnormalities of 26 cases of fetal UPSVS prenatally diagnosed. Results A total of 26 fetuses diagnosed as UPSVS were included, including four cases of type I UPSVS, ten of type II, three of type IIIA, and nine of type IIIB. Four cases of type I were all complicated by fetal heart enlargement and heart insufficiency, of which one case had multiple malformations, and all four cases terminated pregnancies. Six of ten cases of type II terminated pregnancies, including four of Down’s syndrome, one of twin reversed arterial perfusion sequence, one of fetal edema but with normal copy number variation (CNV) by chorionic villus sampling. The other four of ten cases were isolated type II with normal chromosomes, which were delivered at full term and were normal in growth and development when followed up 34 months after birth. Three cases of type IIIA all terminated pregnancies, of which one had multiple malformations, one had right multicystic dysplastic kidney, and one had fetal heart enlargement and heart failure. Among nine of type IIIB, seven with chromosomal abnormalities and/ or complicated malformations terminated pregnancies, and two with isolated type IIIB and normal chromosomes were delivered at full term, and were normal in growth and development (one was followed up to 33 months after birth and the other 20 months after birth). Conclusion Fetal UPSVS can be clearly diagnosed and typed by prenatal ultrasonography. Fetal prognosis is determined by the types of UPSVS and complicated malformations and/ or chromosomal abnormalities. The probability of fetal chromosomal abnormalities in UPSVS fetuses is related to the ultrasonographic classification.

Published in BMC Pregnancy and Childbirth

ISSN: 1471-2393 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Gynecology and obstetrics
Website: http://bmcpregnancychildbirth.biomedcentral.com

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