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Background: During the embryonic stage, the inferior vena cava (IVC) is an important conduit for the hepatic vein and ductus venosus to drain into the right atrium. For fetuses with IVC abnormalities, the prognosis may be favorable if the condition is not complicated with other malformations, but would be poor if atrial isomerism coexists. In severe cases, edema, intrauterine fetal death, and atrioventricular block may occur. Therefore, comprehensive prenatal ultrasound that provides detailed information about IVC abnormalities may be clinically significant. Methods: A total of 180 fetuses diagnosed with IVC anomalies via prenatal ultrasound at Hospital of Chengdu University of Traditional Chinese Medicine and Sichuan Provincial Maternity and Child Health Care Hospital from January, 2017 to December, 2022 were included in this study. Their ultrasound image characteristics, associated intra- or extracardiac malformations and pregnancy outcomes were retrospectively analyzed. Results: Among the 180 fetuses, 59 cases were diagnosed with interrupted IVC (53 cases with the interruption of the hepatic segment of the right IVC and 6 cases with the interruption of the entire right IVC), 1 case was diagnosed with the stenosis of the hepatic segment of the right IVC, 90 cases were diagnosed with left sided IVC, 29 cases with double IVC, and 1 case with abnormal connection of the IVC to the left atrium. Moreover, 33 cases had intracardiac malformations and 36 cases had extracardiac malformations. Pregnancy outcomes: 160 fetuses were live born, and their prenatal ultrasound diagnoses were confirmed by computed tomography (CT)/magnetic resonance imaging (MRI) or surgery; the remaining 20 fetuses were terminated due to serious malformations, and their prenatal ultrasound diagnoses were confirmed by pathologic examination. Conclusions: Prenatal ultrasound can clearly reveal the fetal IVC abnormalities and the associated intra- or extracardiac malformations. For suspected cases, attention should be focused on prenatal ultrasound examinations in order to obtain valuable information for prenatal consultation and subsequent procedures and care.

The inferior vena cava (IVC) may develop abnormally because of its complex embryogenesis. An understanding of congenital variants such as duplication of the IVC is essential for clinical interventions, particularly those performed by surgeons and radiologists. We herein describe five patients who were diagnosed with duplication of the IVC by computed tomography or angiography and summarize their imaging and clinical features. All five patients were men aged 46 to 78 years. Two of the patients had pulmonary embolism and deep vein thrombosis and were treated by placement of an IVC filter and catheter-directed thrombolysis. The IVC in all patients ascended on either side of the abdominal aorta. All left IVCs terminated in the left renal vein, which crossed the aorta and joined the right IVC. The average follow-up time was 29 months (range, 14-46 months), and no patients developed venous thromboembolism or recurrence of thrombosis. Duplication of the IVC can be diagnosed by computed tomography and angiography. Its course and relationship with the renal vein must be identified for accurate planning of IVC filter placement in the setting of deep vein thrombosis and pulmonary embolism.