23例脐静脉-门静脉-体静脉分流胎儿的产前诊断和产后随访分析

Investigation of the status of prenatal diagnosis and postnatal follow-up of 23 fetuses with umbilical-portal-system venous shunt

Objective?To investigate the current status of the prenatal diagnosis and postnatal follow-up of fetuses with umbilical-portal-system shunt (UPSVS). Methods?23 fetuses with UPSVS, diagnosed by Peking University People's Hospital from July 2013 to June 2020, were divided into three types according to the sonographic features: TypeⅠ, umbilical–systemic shunt (USS); TypeⅡ, ductus venosus–systemic shunt (DVSS); and TypeⅢ, portal–systemic shunt (PSS), which was divided into two subgroups: TypeⅢa, intrahepatic portal–systemic shunt (IHPSS); and TypeⅢb, extrahepatic portal–systemic shunt (EHPSS). Prenatal diagnosis and postnatal follow-up were analyzed retrospectively. Results?Compared with USS (2/23, 8.7%) and DVSS (4/23, 17.4%), PSS was the most common (17/23, 73.9%). The median follow-up time was 43 months(range 12-84). Three cases failed to be followed up. The rate of prenatal multi-disciplinary team (MDT) counselling was 15.0% (3/20). Fetal karyotyping was done at 35.0% (7/20). There were 11 cases opting to terminate the pregnancy, 9 cases with live born fetuses. Only 4 cases (4/9, 44.4%) had regular pediatric examination, compared with 2 cases with irregular examination and 3 cases without any examination. Conclusion?Prenatal MDT, genetic screening, and postnatal pediatric follow-up related to USPVS need to be further improved.