PERSISTENT RIGHT UMBLICAL VEIN WITH DUODENAL ATRESIA AND POLYHYDRAMNIOS: A RARE CASE REPORT WITH REVIEW OF LITERATURE

Persistent right umblical vein (PRUV) is an altered embryonic development during fourth to seventh week of gestation when left umbilical vein (UV) regresses but right umbilical vein remains patent. In normal early foetal development, obliteration of right UV begins at four weeks and disappears at seven weeks, leaving the left umbilical vein as single vein within umbilical cord. PRUV is a rare entity with incidence of 1/250 – 1/1250. It may be isolated or associated with other anomalies related to genitourinary, gastrointestinal, cardiac, and skeletal system. In this case, thirty years primigravida visited ANC for routine check-up. She regularly took folic acid and was not exposed to teratogens. Risk of chromosomal anomaly was low with double marker and NT scan. Detailed anomaly scan at twenty weeks showed PRUV and prominent stomach . Foetal echo was normal. In third trimester fundal height was more than period of gestation (POG). USG at 36 weeks showed duodenal atresia and polyhydramnios with double bubble sign. She was monitored till onset of labour and delivered female baby weighing 2.8 kg. Surgery was done on second postnatal day for duodenal atresia. Baby is doing well in postnatal period. So, it was concluded that PRUV is a rare entity and can be associated with other anomalies. Patient should be followed up further and counselled regarding possible outcome. Though duodenal atresia is associated with Down syndrome in around 30% cases, yet our patient had favourable outcome. Keywords: Umblical vein; Chromosomal anomaly; Down syndrome