Fetal prognosis in varix of the intrafetal umbilical vein.

Abstract

To assess the clinical significance of varix of the intraabdominal portion of the umbilical vein, we reviewed 10 cases diagnosed prenatally by ultrasonography at a median gestational age of 27 weeks. A comprehensive anatomic survey and serial follow-up scans were performed in each case. All three fetuses with associated anomalies died in utero, and prenatal karyotyping revealed that two of them had a chromosomal abnormality. In six of the seven cases with structurally normal fetuses the pregnancy proceeded uneventfully, and no neonatal complications were attributed to the umbilical vein varix. Our experience and the review of the literature revealed 42 cases with information on fetal outcome. Overall, 24% of the fetuses died, 12% had a chromosomal abnormality, and 5% developed hydrops. We conclude that fetuses with varix of the intrafetal umbilical vein should be considered at risk for poor outcome. However, if no other anomalies are present, the prognosis is generally good.

Prenatal diagnosis of fetal intra‐abdominal umbilical vein varix: Report of 2 cases

“…1,2,4 The fetal mortality rates due to varix rupture and thrombosis are 50% and 80%, respectively. 2,6,7 Fetal demise is most likely to occur at the gestational age of 27-30 weeks 5 because of the increased risk of rupture and thrombosis of the FIUVV due to increased fetal blood flow. This explains why FIUVV diagnosed late in pregnancy may not cause any problem, as in our 2 cases.…”

“…Patients with FIUVV should be closely monitored with sonography and should be informed about the possible adverse outcomes. 1,7,8 Delivery should be induced at 34-36 gestational weeks, when the fetal lung is mature. …”

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

“…A peculiarity in our observation is the too early diagnosis term as the median gestational age at diagnosis is 27 weeks [5]. In his review of …”

“…FIUVV is defined as an intra-abdominal umbilical vein diameter at least 1.5 times greater than the diameter of the intra-hepatic umbilical vein [5] or an intra-abdominal umbilical vein diameter exceeding 9 mm [6]. Strict quality criteria must be applied to hold the diagnosis.…”

Sonographic assessment of the umbilical cord

“…50,51 The umbilical vein varix is diagnosed if the vein diameter is greater than 8 mm, 51 or the lumen of the varix measures 50% larger diameter that the intrahepatic portion of the umbilical vein. 52 The significance of the umbilical vein varix is related to the presence of associated fetal abnormal findings, and adverse pregnancy outcome. Few reports associated umbilical vein varix with the fetal chromosomal abnormalities.…”