OC05.05: Absent ductus venosus: prognosis in the era of first trimester screening for chromosomal abnormalities

Absent ductus venosus (ADV) has been related to poor fetal outcome. The aim of this study was to assess ADV prognosis in the era of early prenatal diagnosis according to associated risk factors and type of drainage. Prospective study of consecutive prenatal ADV diagnosed at two tertiary centers from 2005 to 2012. Prenatal findings and outcome were examined. Clinical data were analyzed to classify the ADV as isolated or associated with other structural abnormalities or cardiac failure. Umbilical vein drainage type and relationship between ADV and nuchal translucency (NT) were assessed. 51 ADV were diagnosed: 31 (60.7%) intrahepatic (IADV) and 20 (39.2%) extrahepatic (EADV). Twenty-eight cases (54.9%) had associated anomalies, of these 23.5% were isolated cardiovascular malformations, 19.6% complex or minor defects and 13.7% portal system anomalies. Fourteen (27.4%) were complicated by heart failure and eighteen (33.3%) had no associated anomalies or complications. Overall survival rate (SR) was 68.6% (100% among the isolated cases and 52.9% in those with associated anomalies or cardiac failure). The combined pregnancy termination and perinatal loss rate in ADV with associated structural anomalies was 42.8% and with heart failure 64.3%. IADV had a better prognosis than EADV (SR: 83.8% versus 45%) (p = 0.04). Seven genetic/chromosomal disorders were diagnosed postnatally. IADV is more prevalent than EADV. Isolated and non-complicated ADV is more common than previously reported and is associated with good perinatal outcome.