Ultrasonographic characteristics and outcome of fetal intrahepatic umbilical-porto-systemic venous shunts: a single-center study.

OBJECTIVE

To investigate fetal intrahepatic umbilical-portal-systemic venous shunts (IHUPSVS).

METHODS

The study retrospectively analyzed cases of IHUPSVS at a single center from January 2015 to December 2024. Ultrasonographic features, IHUPSVS types, and postnatal outcomes were recorded and followed up.

RESULTS

Overall, 30 IHUPSVS cases, including 22 Type I (17 Ia and five Ib), two Type II, three Type III, and three Type IV cases, were identified. As gestational age increased, compensatory dilation of the hepatic artery (HA), cardiomegaly, fetal growth restriction (FGR), and abnormal hemodynamics became more prevalent. Type I was mainly linked to FGR. Types II and III showed compensatory dilation of the HA and cardiomegaly. All types were associated with fetal structural malformations, with Type IV being the most prominent. Eleven pregnancies were terminated, and 19 live births occurred, with natural closure.

CONCLUSION

Prenatal ultrasound is useful for diagnosing IHUPSVS, monitoring fetal growth and hemodynamics, and predicting prognosis by IHUPSVS types.