Journal of Ultrasound in Medicine, Vol 15, Issue 5 371-374, Copyright © 1996 by American Institute of Ultrasound in Medicine
Persistent intrahepatic right umbilical vein: a prenatal sonographic series without significant anomalies
C. F. Kirsch, V. A. Feldstein, R. B. Goldstein and R. A. Filly
Department of Radiology, University of California, San Francisco 94143-0628, USA.
Umbilical venous anatomy variation is considered extremely rare. The
intrahepatic persistent right umbilical vein represents one version in the
spectrum of umbilical vein variations. Prior reports of a prenatally
diagnosed persistent right umbilical vein suggest it is strongly associated
with severe fetal anomalies including congenital heart disease and
gastrointestinal malformations. Our experience contrasts with these
findings. Nine cases of intrahepatic persistent right umbilical vein were
identified via prenatal sonography between July 1992 and January 1994. The
gestational ages of the fetuses ranged from 20 to 36 weeks. Targeted fetal
surveys were performed in all nine fetuses and formal fetal echocardiograms
were obtained in six. All nine infants have been delivered. In nine cases,
the intrahepatic persistent right umbilical vein was an isolated
observation with no abnormalities identified pre- or postnatally except one
case of hypospadias. Formal fetal echocardiography was normal in all six of
the fetuses studied. Given previous reports describing a high risk of
congenital malformations in association with the presence of a persistent
right umbilical vein, the sonographic finding of this anomaly should still
prompt targeted fetal sonography and fetal echocardiography. However, our
series indicates that this vascular variant may occur as an isolated
abnormality and may not necessarily represent the ominous finding suggested
previously.
