Prenatal diagnosis of isolated interrupted inferior vena cava with azygos continuation to superior vena cava
A 38-year-old second gravida was referred to us for fetal echocardiography at 25 weeks in view dilated superior vena cava (SVC) and suspicion of interrupted IVC with persistent right umbilical vein. Biometry was consistent with fetal age. No other abnormalities were detected within the heart or other organs. Fetal karyotype was normal. Fetal echocardiography showed the presence of a vessel posterior to the descending aorta in the four-chamber view (“Double vessel sign,” ). The next clue came from the three-vessel view, which showed a dilated, prominent SVC []. In the bi-caval view, the intra-hepatic portion of the inferior vena cava was found to be interrupted []. Rostral to this point, a thinner vessel with venous flow was detected as a continuation of the infra-hepatic portion of the IVC. On tracing this vessel cranially, its connection with the superior vena cava was documented []. The hepatic veins and ductus venosus reached the right atrium normally. No other anomalies of the heart were detected.\nA female baby weighing 2.8 Kg was delivered by elective caesarian section at 38 weeks. Clinical evaluation of the cardio-vascular system was unremarkable. A detailed cardiac evaluation was performed at 6 weeks post-natal age. ECG was unremarkable and showed sinus rhythm with normal atrio-ventricular conduction. Echocardiography confirmed the prenatal diagnosis of isolated inferior vena cava with azygos continuation to superior vena cava []. No other cardiac/extracardiac abnormalities were detected. The patient was advised follow-up and periodic monitoring for the development of any rhythm anomalies in future.