Outcome of pregnancy after prenatal diagnosis of umbilical vein varix.

Rahemtullah, Aliyah; Lieberman, Ellice; Benson, Carol B.; Norton, Mary E.

doi:10.7863/jum.2001.20.2.135

Cited by 61 publications

(74 citation statements)

References 6 publications

(13 reference statements)

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“…It has been described in patients with Turner's syndrome, Noonan syndrome, trisomy 18, Goldenhar syndrome, Ellis Van Crevald syndrome, velocardiofacial syndrome and Down's syndrome [13,14]. Two patients with trisomy 21 have been reported with PSS possibly due to altered angiogenesis of the vitello-umbilical plexus [13].…”

Section: Discussionmentioning

confidence: 99%

Postprandial Hyperinsulinaemic Hypoglycaemia Secondary to a Congenital Portosystemic Shunt

et al. 2015

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Background: Portosystemic shunts (PSS) are abnormal vascular connections between the portal vein or its tributaries and the systemic vein that allow mesenteric blood to reach the systemic circulation without first passing through the liver. PSS can be associated with various syndromes and can lead to serious complications. We report a rare case of a child with PSS and recurrent hypoglycaemia. Case: A 20-month-old girl with Down's syndrome presented with recurrent hypoglycaemic episodes. She had multiple anomalies including a ventricular septal defect, oesophageal atresia and tracheo-esophageal fistula, gastro-oesophageal reflux, and conjugated hyperbilirubinaemia. The initial investigations suggested hyperinsulinaemic hypoglycaemia (HH). She did not respond to diazoxide. An oral glucose tolerance test suggested postprandial HH. Further vascular imaging showed a side-to-side portocaval shunt (Abernethy malformation) with relative hypoperfusion of the liver. Hypoglycaemia resolved following surgical closure of the portocaval shunt. Conclusion: PSS can rarely be associated with HH, possibly due to lack of insulin degradation in the liver. Surgical closure of the shunt resolves the hypoglycaemia.

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Section: Discussionmentioning

confidence: 99%

Postprandial Hyperinsulinaemic Hypoglycaemia Secondary to a Congenital Portosystemic Shunt

et al. 2015

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…2,6 Hydrops fetalis, fetal anemia, diaphragmatic hernia, shortening of the long limbs, hydrocephaly, oligo-and polyhydramnios, and growth retardation are anomalies that have been described in association with FIUVV. Trisomy 21, 9, and 18 and triploidy are also possibly associated with FIUVV.…”

Section: Discussionmentioning

confidence: 99%

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

İpek

Kurt

Tosun

et al. 2007

J of Clinical Ultrasound

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Fetal intra-abdominal umbilical vein varix (FIUVV) is a focal aneurysmal dilatation of the umbilical vein. Its clinical importance has not yet been clearly established, but it has been reported to be associated with increased fetal death rate (in nearly 44% of cases) and chromosomal abnormalities (in 12% of cases). We report 2 cases of FIUVV diagnosed via sonography in the third trimester. 1,2 With the development of sonography and Doppler sonography, diagnosis has become easier than in the past.The clinical importance of FIUVV has not yet been clearly established, but it has been reported to be associated with increased fetal death rate (in nearly 44% of cases) and chromosomal abnormalities (in 12% of cases).1-3 We report 2 cases of FIUVV diagnosed via sonography in the third trimester. CASE REPORTS Case 1A 31-year-old healthy woman, gravida 2, para 1, was referred to our radiology department for sonographic examination. Her first pregnancy was normal. A second-trimester sonographic examination at another institution was unremarkable. The examination was performed with a Voluson 730 Expert (GE Medical Systems, Milwaukee, WI) equipped with a 2-5-MHz curved-array probe. A normal intrauterine fetus of nearly 29 weeks' gestational age was present according to the patient's last menstrual period and sonographic measurements. The biparietal diameter was 69 mm, the femur length was 55 mm, and the abdominal circumference was 248 mm. The estimated fetal weight was 1,300 g with normal amniotic fluid index, umbilical artery, and uterine artery pulsatility index. However, intra-abdominal umbilical vein varix with transverse diameter of 11 mm over an 18-mm segment was diagnosed near the anterior abdominal wall ( Figure 1A). Color Doppler analysis also showed turbulent flow in the varicose segment ( Figure 1B). Otherwise, the fetus was structurally normal. The patient declined chromosomal investigation. Weekly sonographic monitoring was recommended, but the patient did not return for follow-up examinations. She delivered a healthy girl weighing 2,600 g via cesarean section peformed at 35 gestational weeks at another institution. Case 2A 29-year-old woman, gravida 1, para 0, was referred for sonographic examination at approximately 36 weeks' gestation according to her last menstrual period and sonographic measurements. The patient had a second-trimester examination at another institution that was reportedly

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“…The most common complications of FIUVV described in the literature include rupture of the aneurysm, thrombosis, compression of the umbilical artery and other veins, and cardiac failure due to vascular stealing by the varix and increased preload [10]. The overall frequency is assessed at 10%.…”

Section: Discussionmentioning

confidence: 99%

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

Bouzid¹,

Karmous²,

Trabelsi³

et al. 2016

Gynecol Obstet

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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.

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Outcome of pregnancy after prenatal diagnosis of umbilical vein varix.

Cited by 61 publications

References 6 publications

Postprandial Hyperinsulinaemic Hypoglycaemia Secondary to a Congenital Portosystemic Shunt

Postprandial Hyperinsulinaemic Hypoglycaemia Secondary to a Congenital Portosystemic Shunt

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

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

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