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1、292jum_online.qxp:Layout11/20/1010:44AMPage307CaseReportPrenatalFeaturesofOmphaloceleandAbsentDuctusVenosusCaseWithaFavorablePostnatalOutcomeAkikoTanaka,MD,YukikoKondo,MD,NobuhiroHidaka,MD,PhD,YasuoYumoto,MD,PhD,YasuyukiFujita,MD,PhD,KotaroFukushima,MD
2、,PhD,NorioWake,MD,PhDbsenceoftheductusvenosus(ADV)isararevascularanomaly;however,theadventofcolorDopplersonographyhasfacilitateddetailedanalysisofthefetalvenoussystem,andprenataldiagnosishasbeendescribedintherecentAliterature.1–16Theductusvenosusisasho
3、rtvascularchannelwithamaxi-mumdiameterof2mm,whichconnectstheintra-abdominalumbilicalveinwiththeinferiorvenacava(IVC).Becauseofitsroleasasphincterintheisthmicportion,theductusvenosusregulatestheproportionofumbilicalveinreturn,thusprotectingthefetusfrome
4、xcessiveplacentalflow.Congenitalabsenceofthisnarrowvesselleadstolackofthisregulation,andsubsequentvolumeoverloadcanplaceasubstantialbur-denonfetalmyocardialperformancewiththeriskofhigh-outputcardiacfailure.Ifthechronicvolumeoverloadissevere,cardiomegal
5、y,polyhydramnios,andfluidaccumu-lationsuchaspleuraleffusion,ascites,pericardialeffusion,andskinedemamayoccur.Furthermore,ADVisassociatedwithahighincidenceofotheranomalies.Becauseofitshighincidenceofassociatedanomaliesandhydropsfetalis,fetuseswithADVhav
6、eahighmortalityrate.1–3Themostfrequentlyreportedassociatedanomalyiscongeni-talheartdisease.NoreportstodatehaveassociatedADVwithacongenitalabdominalwalldefect.HerewedescribethecaseofafetuswithomphalocelewithextracorporealliverinassociationwithADV,whichw
7、asdiagnosedprenatally.Thefetusshowedpoly-hydramnios,cardiomegaly,andunilateralpleuraleffusionassignsofcardiacimpair-ment;however,thisconditiondidnotdevelopthroughoutthepregnancy,andtheneonatesurvived.AbbreviationsCaseReportADV,absenceoftheductusvenosus
8、;IVC,inferiorvenacavaA33-year-oldwoman,gravida1,para0,wasreferredtoourhospitalforfetalomphaloceleidentifiedat28ReceivedSeptember11,2009,fromtheDepartmentweeks’gestation.ThepregnancyhadotherwisebeenofObstetricsandGynecology,GraduateSchoo
