title: Prenatally diagnosed congenital portosystemic shunts.
abstract: OBJECTIVE
  Congenital portosystemic shunts (CPSS) are rare, congenital malformations that are increasingly often discovered during the fetal period, and for which, the manifestations and evolution are poorly understood. The objective of this review is to describe the phenotype and evolution of forms diagnosed in the antenatal period.
  
  
  METHODS
  We performed a systematic review of the literature cited in Pubmed between 1982 and 2016 for CPSS cases diagnosed during the fetal period.
  
  
  RESULTS
  We identified 123 cases. The median age at diagnosis was 25 GA (14-38 weeks GA). Eighty patients had 128 associated congenital anomalies. The congenital abnormalities most frequently associated with antenatal diagnosis of CPSS were congenital cardiac disease (30 cases), intrauterine growth restriction (21 cases), vascular anomalies (14 cases), and trisomy 21 (7 cases). Seventy-five complications were reported in the literature. The most frequent were antenatal hemodynamic abnormalities (27 cases), neonatal cholestasis (11 cases), and hyperammonemia (10 cases). Twenty-nine patients had no complications. The choice of treatment was conservative in 29/56 cases, interventional radiology in 15 cases and surgery in 15 cases (three of the latter after failure of embolization).
  
  
  CONCLUSIONS
  From this review, we propose an algorithm for the perinatal management of this congenital abnormality.
authors.affiliation: a Service de réanimation néonatale, Hôpital Archet, CHU de Nice , Nice , France.
authors.forename: Bérengère
authors.initials: B
authors.lastname: Francois
authors.affiliation: b Service d'hépatologie, gastro-entérologie et nutrition pédiatrique, Hôpital Femme-Mère-Enfant, CHU Lyon , Lyon , France.
authors.forename: Alain
authors.initials: A
authors.lastname: Lachaux
authors.affiliation: c Service d'hépatologie, gastro-entérologie et nutrition pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille , Lille , France.
authors.forename: Fréderic
authors.initials: F
authors.lastname: Gottrand
authors.affiliation: a Service de réanimation néonatale, Hôpital Archet, CHU de Nice , Nice , France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: De Smet
mesh_terms: D000465:Algorithms; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D054079:Vascular Malformations / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy
keywords: Congenital portosystemic shunt; antenatal diagnosis; perinatal management; portocaval shunt; vascular disease