Ductus venosus
Vein in the human fetus
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Anatomic course
The pathway of fetal umbilical venous flow is
umbilical vein left portal vein ductus venosus inferior vena cava eventually right atrium.
This anatomic course is important to recall when assessing the success of neonatal umbilical venous catheterization, as failure to cannulate through the ductus venosus results in malpositioned hepatic catheterization via the left or right portal veins. Complications of such positioning can include hepatic hematoma or abscess.
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Postnatal closure
The ductus venosus is open at the time of birth, and that is the reason why a catheter inserted into the umbilical vein (umbilical vein catheterization / "UVC") can reach the inferior vena cava; absent a patent DV, such a catheter would continue into the portal vein. The ductus venosus naturally closes during the first week of life in most full-term neonates; however, it may take much longer to close in pre-term neonates. Functional closure occurs within minutes of birth. Structural closure in term babies occurs within 3 to 7 days.
After the ductus venosus closes, its remnant is known as ligamentum venosum.
If the ductus venosus fails to occlude after birth, it remains patent (open), and the individual is said to have a patent ductus venosus and thus an intrahepatic portosystemic shunt (PSS). This condition is hereditary in some dog breeds (e.g. Irish Wolfhound). The ductus venosus shows a delayed closure in preterm infants, with no significant correlation to the closure of the ductus arteriosus or the condition of the infant. Possibly, increased levels of dilating prostaglandins leads to a delayed occlusion of the vessel.