Fetal Intra-abdominal Umbilical Vein Varix: A Case Report and Literature Review

Abstract

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.

Extra-abdominal umbilical vein varix in a newborn

“…Umbilical vein varices are rare fetal anomalies typically found intra-abdominally and identified on ultrasound prior to birth. Intra-abdominal umbilical vein varices account for approximately 4% of umbilical cord abnormalities and are thought to be a developmental abnormality rather than a congenital malformation 1. There have been few case reports of extra-abdominal varices, which are typically identified as a postnatal diagnosis, and most of which are diagnosed retrospectively during autopsy 2.…”

“…An extra-abdominal umbilical varix is difficult to diagnose prenatally as it can appear like a cyst on ultrasound prior to birth. Confirmation of the diagnosis requires pathology 1. Classification of an intra-abdominal umbilical vein varix includes measurement of an umbilical vein diameter ≥9 mm or wider than 50% the diameter of the intrahepatic umbilical vein 3.…”

Imaging of Placental Pathology

“…Umbilical vein varices are rare (Fig. 32.12); these vein varices are mostly found intra-abdominally, although some cases of extra-abdominal varices have been described [16,22,33]. On ultrasound examination, an intra-abdominal vein varix mostly appears as a cystic mass [33].…”