Absent Ductus Venosus

A patient was referred for a detailed anatomy survey due to Advanced Maternal Age. Upon ultrasound examination, ascites was initially suspected, but Doppler imaging revealed unexpected blood flow. Further evaluation confirmed an absent ductus venosus with the umbilical vein draining directly into the right atrium. 

Additional findings included a single umbilical artery, persistent left superior vena cava, an apically offset mitral valve relative to the tricuspid valve, a duplicated right renal artery, and velamentous cord insertion. Due to the umbilical vein’s direct drainage into the right atrium, the perinatologist noted an increased risk for congestive heart failure. These findings were also associated with Noonan Syndrome. 

An amniocentesis was performed and returned normal. A follow-up ultrasound later detected pericardial effusion and ventriculomegaly, both of which have since resolved. The patient remains under close monitoring until delivery.