Isolated Ductus Venosus Systemic Shunt: A Rare Case Report

Abstract Abnormal drainage of the ductus venosus (DV) into the systemic venous circulation is a rare prenatal finding, historically associated with cardiac, chromosomal, or gastrointestinal anomalies. We present a case of a systemic shunt (type II umbilico-portal systemic venous shunt) diagnosed during a routine early second-trimester scan at 17 weeks of gestation. Using color and spectral Doppler, we confirmed an aberrant horizontal course of the DV draining into the inferior vena cava at a caudal level than normal. Importantly, the intrahepatic portal venous system was preserved. Longitudinal follow-up through the 26th week demonstrated stable cardiac dimensions and no signs of volume overload. This case highlights that in the presence of a normally developed portal system, isolated DV systemic shunts may follow a benign clinical course, warranting a conservative management approach.