Prenatal diagnosis of fetal intra-abdominal umbilical vein varix: Report of 2 cases (original) (raw)
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Prenatal diagnosis and management of fetal intra-abdominal umbilical vein varix
Journal of family medicine and primary care
Fetal intra-abdominal umbilical vein varix (FIUVV) is a rare pathology and suggests an enlargement of the umbilical vein. Prenatal diagnosis is done through meticulous ultrasound imaging. Management variables are the diameter of varix, presence or absence of turbulent flow, and fetal anomalies. Color and power Doppler ultrasound helps in diagnosis and follow-up and has a critical role in decision-making for intervention. Clinical guidelines for management are not clear. The adverse fetal outcome is usually associated with multiple malformations, turbulent flow, and thrombotic varix. This case study presents the prenatal diagnosis, obstetric management, and neonatal development of a fetus, diagnosed with FIUVV along with a brief review of the literature.
Fetal Intra-abdominal Umbilical Vein Varix: A Case Report and Literature Review
Gynecology & Obstetrics, 2016
Fetal intra-abdominal umbilical vein (FIUV) varix is a rare malformation of the umbilical cord. This is a critical situation due to discrepancies in outcomes varying from normal to high rates of complications and fetal mortalities. We report the observation of a FIUVV vein diagnosed precociously at 22 weeks with a quiet increasing of the diameter by 31 weeks. The outcome was favourable and close monitoring after birth showed no anomalies. Despite a good prognosis it seems that a close monitoring is essential in antenatal period. Figure 1: Longitudinal and axial section of the fetal abdomen showing an intra-abdominal cystic dilatation on path of the umbilical vein. G y n e c o lo gy & O b s te tr ic s
Pregnancy outcome after ultrasound diagnosis of fetal intra-abdominal umbilical vein varix
Ultrasound in Obstetrics & Gynecology, 2009
ObjectivesFetal intra-abdominal umbilical vein (FIUV) varix is a focal dilatation of the intra-abdominal portion of the umbilical vein, which has been reported to be associated with intrauterine death and other anomalies. Our aim was to examine our experience with this diagnosis at a single tertiary-care center and to correlate it with clinical outcome.Fetal intra-abdominal umbilical vein (FIUV) varix is a focal dilatation of the intra-abdominal portion of the umbilical vein, which has been reported to be associated with intrauterine death and other anomalies. Our aim was to examine our experience with this diagnosis at a single tertiary-care center and to correlate it with clinical outcome.MethodsThis was a retrospective case series study. Our ultrasound database was searched for all cases with a diagnosis of FIUV varix identified at our facility between 1997 and 2007. We reviewed all ultrasound examinations, maternal antenatal records, delivery records and newborns' medical records.This was a retrospective case series study. Our ultrasound database was searched for all cases with a diagnosis of FIUV varix identified at our facility between 1997 and 2007. We reviewed all ultrasound examinations, maternal antenatal records, delivery records and newborns' medical records.ResultsWe identified 52 cases of FIUV among a population of approximately 68 000. Three cases of trisomy 21 were identified, all of which were accompanied by other anomalies. There was intrauterine death of one fetus with trisomy 21 at 35 weeks of gestation. We did not find an association between FIUV varix and other obstetric complications.We identified 52 cases of FIUV among a population of approximately 68 000. Three cases of trisomy 21 were identified, all of which were accompanied by other anomalies. There was intrauterine death of one fetus with trisomy 21 at 35 weeks of gestation. We did not find an association between FIUV varix and other obstetric complications.ConclusionsThe outcome of pregnancies with FIUV varix is generally favorable. The finding of a FIUV varix should prompt the search for other anomalies, especially markers of aneuploidy. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.The outcome of pregnancies with FIUV varix is generally favorable. The finding of a FIUV varix should prompt the search for other anomalies, especially markers of aneuploidy. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Obstetrics & gynecology science, 2014
This study reviewed clinical characteristics of fetal intra-abdominal umbilical vein (FIUV) varices that were detected during antenatal ultrasound examinations. Between January 2006 and January 2012, 121 cases of FIUV varices were detected and 7 cases were lost to follow-up. We retrospectively reviewed the medical records of 114 patients and neonates. From a total 96,553 ultrasound examinations in 43,995 pregnancies, 121 cases of FIUV varices were identified (2.8 per 1,000 pregnancies). Gestational age at diagnosis was 32.0 ± 2.9 weeks (range, 20.1-36.3 weeks), the mean diameter of the FIUV varix was 12.6 ± 2.1 mm (range, 8.0-21.0 mm) at initial diagnosis and the mean maximal diameter was 13.1 ± 2.3 mm (range, 8.0-21.0 mm) during follow-up. The most severe pregnancy complications included one case of intrauterine fetal death and another case of fetal hydrops. Associated fetal anomalies (n = 11, 9.6%) detected by ultrasonography included bilateral renal pelvis dilatation, ventriculom...
Intra-Abdominal Umbilical Vein Varix – A Case Report
International Journal of Recent Surgical and Medical Sciences, 2015
The incidence of the fetal intra-abdominal umbilical vein varix condition is very rare and has been associated with fetal hydrops, IUGR and still birth A 26-year-old primigravida was referred for routine antenatal scan. The scan at 30 weeks showed an intra-abdominal ovoid structure superior to the fetal bladder. Color flow Doppler revealed venous flow in continuity with the umbilical vein. A diagnosis of umbilical varix was made. The venous flow was present throughout the lesion, suggesting the absence of thrombi. There was no evidence of fetal hydrops. Subsequent scans at regular intervals showed no increase in size of the umbilical varix. The patient had an uneventful elective cesarean section at 39 weeks. Postnatal assessment and a follow-up neonatal cardiac echo scan were normal. Our case supports the new emerging evidence that pregnancy outcome in cases of isolated fetal umbilical vein varix is generally good. Caution must be exercised against unnecessary early induction and co...
Isolated Fetal Intra-Abdominal Umbilical Vein Varix
Journal of Ultrasound in Medicine, 2011
fetal intra-abdominal umbilical vein varix is defined by an index portion of the umbilical vein that is at least 50% wider than the nondilated portion or dilatation of 9 mm or greater. 1 Others have defined it as a measurement that is more than 2 SDs above the mean for gestational age. The first description of a fetal intra-abdominal umbilical vein varix was of several cases with grave fetal outcomes, 3 and most of the initial studies were case reports with mortality rates of up to 43%. For many years, cases of isolated fetal intra-abdominal umbilical vein varices have not been differentiated from cases associated with other fetal structural or chromosomal abnormalities. Approximately 150 cases of isolated fetal intra-abdominal umbilical vein varices have been described in the last 3 decades. In recent reports, the neonatal prognosis was found to be substantially better than that reported in older studies. In this series, we describe our experience with cases of an isolated fetal intra-abdominal umbilical vein varix. This series adds to other recent studies reporting rather reassuring outcomes of fetuses with fetal intra-abdominal umbilical vein varices. This information affects fetal surveillance and preterm labor induction policies in these cases.
Perinatal outcomes of fetal intra-abdominal umbilical vein varix: a multicenter cohort study
Objectives: To investigate the perinatal outcomes of fetuses with antenatal diagnoses of intraabdominal umbilical vein varix (UVV). Methods: A multicenter retrospective study was conducted in four countries on fetuses diagnosed with intra-abdominal UVV between 2012 and 2019. Collected data included gestational age (GA), UVV maximum diameter at diagnosis and delivery, associated anatomical and chromosomal anomalies, birth weight, and neonatal outcomes. Results: Twenty fetuses were identified, of which 20% had associated chromosomal and/or anatomical abnormalities, most resulting in poor outcomes (either intrauterine fetal death or pregnancy termination). Mean maternal age was 34.1 ± 7.0 years, UVV was diagnosed at 26.5 ± 4.5 weeks of GA on average with a maximum diameter of 12.0 ± 4.0 mm. Mean GA at delivery was 35.4 ± 5.6 weeks. Survival rate was 85%. Conclusion: Our study shows a satisfactory outcome when intra-abdominal UVV is an isolated finding, with minimal obstetrical and perinatal consequences. The prognosis is worse when UVV is associated with other anomalies.