Evaluation of the type of fetal umblical‐portal anastomosis in late‐onset fetal growth restriction: A case–control study

Abstract

AbstractPurposeTo evaluate the type of umbilical‐portal anastomosis in late‐onset fetal growth restriction (LO‐FGR) and appropriate for gestational age (AGA) fetuses. To investigate the impact of the type of umbilical‐portal anastomosis on the adverse outcomes in LO‐FGR.MethodThis study observed 150 pregnancies with AGA fetuses and 62 pregnancies with fetuses with LO‐FGR. In each case, the point of reference for measuring the abdominal circumference was established. The type of umbilical‐portal anastomosis was evaluated as T‐shaped, X‐shaped, and H‐shaped according to the shape of main portal vein and portal sinus. Incidences of the type of umbilical‐portal anastomosis in AGA and LO‐FGR fetuses were evaluated.ResultsT‐shaped anastomosis was the most common (56.7%) in the AGA group and X‐shaped (66.1%) in the LO‐FGR group. In LO‐FGR, T‐shape anastomosis was significantly lower and X‐shape anastomosis was significantly higher than AGA (p < 0.001). X‐shaped anastomosis was associated with LO‐FGR and the RR was 2.3 (95% CI 1.5–3.6; p < 0.001). Incidences of admission to NICU and emergency C/S for fetal distress were higher in fetuses with X ‐shaped anastomosis in the LO‐FGR (p < 0.05).ConclusionX‐shaped umbilical‐portal anastomosis have a prognostic significance in LO‐FGR fetuses.