Giant dilatation of the umbilical vein

Fuster, Juan Sebastian; Benasco, C; Saad, Imad

doi:10.1002/jcu.1870130516

Cited by 31 publications

(31 citation statements)

References 7 publications

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“…A varix of the umbilical vein has been associated with intrauterine death and hydrops fetalis, but large differences in fetal outcomes among reported series are present (table 5) [3,4,12,[15][16][17][18][19][20][21][22][23].They can be explained by several factors, e.g., associated malformations, fetuses with significant IUGR, and gestational age at the time of the diagnosis, but prognostic factors for varix of the umbilical vein are poorly known.…”

Section: Varix Of the Umbilical Veinmentioning

confidence: 99%

Anomalies of the Fetal Venous System: A Report of 26 Cases and Review of the Literature

Viora

Sciarrone²,

Bastonero³

et al. 2004

Fetal Diagn Ther

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Objective: To evaluate sonographic appearance, natural history, and neonatal outcome of fetal venous anomalies. Methods: We performed an observational study, including all fetuses affected by abnormalities of the venous system diagnosed by ultrasound during the prenatal period. Results: 26 fetuses were identified. Other malformations were present in 5 cases (19.2%), 1 fetus had trisomy 21, and 1 fetus had intrauterine growth retardation (IUGR). Twenty-five pregnancies ended in liveborn infants, and there was 1 case of unexplained intrauterine death in the fetus with IUGR affected by varix of the umbilical vein. Conclusions: Fetal venous anomalies are very rare and may be associated with fetal malformations or IUGR. Conservative management appears to be an adequate medical practice in the absence of other fetal problems, but in the presence of a varix of the umbilical vein, serial follow-up scans are needed to exclude the onset of hydrops or thrombosis of the varix.

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Section: Varix Of the Umbilical Veinmentioning

confidence: 99%

Anomalies of the Fetal Venous System: A Report of 26 Cases and Review of the Literature

Viora

Sciarrone²,

Bastonero³

et al. 2004

Fetal Diagn Ther

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“…A suggested cause of the UVD is the existence of an embryogenetic wall defect of the extrahepatic portion of the UV most likely at sites of weak musculature. However, in the only case where a microscopic evaluation of the varix was performed, this hypothesis was not confirmed [2] .…”

Section: Discussionmentioning

confidence: 94%

“…There are only a few reports in the literature that associate this finding with chromosomal abnormalities such as trisomies 21, 18 and 9 as well as triploidy [4,7] . In addition, the commonest associated structural abnormalities in the reported cases are hydrops fetalis, polyhydramnios, and cardiomegaly [2,4,7,9] , which, however, may be transient in some cases [10] . Nevertheless, when UVD is encountered, a detailed ultrasonographic examination including fetal cardiac scanning should be made to exclude other structural abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…In some cases however, intrauterine fetal death may occur [4,7] . In different studies mortality rates range from 0 to 44% [4,10] , and usually intrauterine fetal demise is more common on the ground of other malformations, occurring between 27 and 30 weeks of gestation [2,7] . Interestingly, intrauterine fetal demise has been reported in 3 cases where the dilatation was the only finding [4] .…”

Section: Discussionmentioning

confidence: 99%

“…Fetal intraabdominal UVD is diagnosed by ultrasonogram during the second or third trimester. The first case was published in 1985 by Fuster et al [2] in a fetus with pericardial effusion and ascites. About 100 cases have been reported in the English literature since then.…”

Section: Introductionmentioning

confidence: 99%

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Intraabdominal Umbilical Vein Dilatation and Term Delivery

Mantas¹,

Sifakis²,

Koukoura³

et al. 2007

Fetal Diagn Ther

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Dilatation of the fetal umbilical vein is a rare, most commonly isolated finding. Approximately 100 cases have been reported in the literature that describe different management approaches, especially regarding the time of delivery. We present a new case of umbilical vein dilatation diagnosed at 23 weeks’ gestation as an isolated sonographic finding, in a fetus with short umbilical cord, delivered at 38 weeks’ gestation. The clinical and sonographic features as well as the management options of this uncommon condition are shortly discussed.

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Ultrasonographic diagnosis of ectasia of the umbilical vein

Vesce¹,

Guerrini²,

Perri³

et al. 1987

J of Clinical Ultrasound

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Anomalies of the umbilical cord are associated with high rates of stillbirth, possibly because of fetal hypoxia during pregnancy.' In the past, this pathology was usually detected after delivery, thus preventing any therapeutic measures from being taken to save the infant's life.Progress towards a prenatal diagnosis of umbilical cord defects has been made recently with the introduction of high-resolution ultrasound examination; in this way it was possible to diagnose correctly cases of umbilical cord hematoma,' angiomy~oma,~ and allantoicHere we describe a case of ectasia of the umbilical vein with fetal distress, which we were able to recognize by ultrasonic imaging and successfully treat by elective cesarean section. CASE REPORTA 38-year-old woman, gravida 4 para 3, received a routine ultrasound examination at 34 weeks. Although the placenta, the fetus, and the amount of amniotic fluid were normal, anomalies were found in the umbilical cord. In fact, the portion of the cord close to the abdominal wall of the fetus was normal but was followed by an enlarged segment, initially with a thickening of the wall and later with a dilatation of the umbilical vein (diameter was 9.2 cm) surrounded by a thin wall. In a more distal section, a second smaller dilatation was detected (Fig. 1). Evidence of a turbulent flow in both cavities was seen.The mother was submitted to a number of laboratory investigations, which gave evidence of a severe hypochromic anemia, but clotting function and the values of E3 and HPL were within the normal range. Serologic tests for rubella, toxoFrom the *Clinica Ostetrica e Ginecologica, tIstituto di Puericultura e Medicina Neonatale, and ZIstituto di Anatomia e Istologia Patologica dell'universita di Ferrara, Ferrara, Italy.For reprints contact F. Vesce, MD, Clinica Ostetrica e Ginecologica dell'universita di Ferrara, Ferrara, Italy. plasmosis, syphilis, viral hepatitis, and cytomegalovirus infection were negative.Two weeks later, despite the absence of changes in the echographic picture, a decrease in fetal heart rate variability, with variable decelerations associated with weak uterine contractions, was observed. Clear amniotic fluid was collected by amniocentesis: since the lecithidsphingomyelin ratio was 2.3, a cesarean section was performed with the delivery of a 2,420-g female newborn.The placenta was normal. The umbilical cord, centrally inserted, measured 40 cm in length. At 10 cm from its abdominal end, an enlargement of myxomatous tissue containing normal vessels was present. In the immediate subsequent portion of the cord, the umbilical vein showed a sac, 5 cm in diameter, filled with partially clotted blood, followed by a collapsed thin-walled dilatation (Fig. 2).Microscopic examination revealed that the intima was torn with blood dissecting between the muscle and adventitia toward Wharton's jelly (Fig. 3). There was no evidence of angiitis. The pathologic pattern was consistent with an intramural dissecting hematoma.Birth weight, head circumference, and length of the infant were a...

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Giant dilatation of the umbilical vein

Cited by 31 publications

References 7 publications

Anomalies of the Fetal Venous System: A Report of 26 Cases and Review of the Literature

Anomalies of the Fetal Venous System: A Report of 26 Cases and Review of the Literature

Intraabdominal Umbilical Vein Dilatation and Term Delivery

Ultrasonographic diagnosis of ectasia of the umbilical vein

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