Imperial College, Reproductive Biology at Queen Charlotte's and Chelsea Hospital, London, UK.
Ultrasound Obstet Gynecol. 2013 May;41(5):589-91. doi: 10.1002/uog.12381.
The ductus venosus (DV) connects the portal venous system to the inferior vena cava. Rarely, the umbilical venous drainage is anomalous, either connecting to the portal sinus within the liver or having an extrahepatic connection, bypassing the liver and draining to one of a variety of sites, including to the heart directly. Prenatally, there is a recognized association of anomalous umbilical venous drainage with aneuploidy and other structural malformations. The fetus may also develop right heart failure because of unregulated volume loading. We report the postnatal development of diaphragmatic hernia in three fetuses with absent DV and umbilical venous drainage to the right atrium directly in two cases and to the coronary sinus in the third. In all fetuses, the abnormality was well-tolerated in pregnancy, with only a modest degree of right heart dilatation. All three neonates underwent repair of the diaphragmatic hernia and made a good recovery.
静脉导管（DV）将门静脉系统与下腔静脉连接。罕见情况下，脐静脉引流异常，要么连接到肝脏内的门静脉窦，要么存在肝外连接，绕过肝脏并引流到多种部位，包括直接引流到心脏。在胎儿期，异常的脐静脉引流与非整倍体和其他结构畸形有关。胎儿也可能因不受调节的容量负荷而出现右心衰竭。我们报告了三例 DV 缺失且脐静脉直接引流至右心房（两例引流至右心房，一例引流至冠状窦）胎儿的膈疝的产后发育情况。在所有胎儿中，该异常在妊娠期间耐受良好，仅右心轻度扩张。所有三名新生儿均接受了膈疝修补术，恢复良好。
