FIUVV: Associations and Outcome

Abstract

To investigate the ultrasound characteristics, associations and obstetric outcomes in pregnancies with intra-abdominal umbilical vein varix of the fetus. This was a retrospective cohort study conducted over 2 years from March 2019 to February 2021. The data collected were demographic characteristics, varix characteristics, obstetric complications (fetal growth restriction/IUFD) and neonatal outcomes. Descriptive statistics (means, standard deviations, and percentages [%]) were calculated using SPSS, version 21.0 (SPSS Inc, Chicago, USA). Over the period of 2 years, six cases of FIUVV were diagnosed putting the incidence of FIUVV at 5/10000 pregnancies. The incidence of isolated FIUVV was 4.4/10000 cases. Mean gestational age at diagnosis was 25 weeks 3 days with earliest diagnosis at 19w1D. Mean varix size was 11.85 mm ± 2.28 mm (range 8.9–14.8 mm). No incidence of turbulence or thrombus formation within the varix was seen in the current study. One case had absent DV with anomalous drainage of the umbilical vein in to the IVC along with pleural effusion, polyhydramnios and increased nuchal fold thickness. Perinatal death after planned LSCS at term was noted in this pregnancy. One case had rapid dilatation of the varix from 9.5 at 19 weeks to 15.4 mm at 27 weeks. The patient reported sudden IUFD at 33 weeks. The association of FIUVV with the adverse obstetrical outcomes was seen in some cases during the current study. Increased surveillance to look for rapid dilatation/ turbulence/ thrombosis may prevent adverse perinatal outcomes.