Prenatal renal vein thrombosis in dichorionic twin pregnancy

Abstract

Fetal renal vein thrombosis may occur bilateral and may also involve the inferior vena cava. Rapid deterioration of fetal condition, abnormal fetal Doppler, appearance of hydrops fetalis, may accompany fetal venous thrombosis. By color Doppler flow mapping abnormal arterial and absent venous perfusion of the affected kidney may be demonstrated in addition.

Prenatal Diagnosis of Renal Vein Thrombosis: A Case Report and Literature Review

“…One case had a paternal 4G PA1 gene mutation. Factor V Leiden and methylene tetrahydrofolate reductase (MTHFR) gene mutations were reported in 1 infant [6,20]. The association of diabetes mellitus and RVT deserves further research.…”

“…van der Vange and Bruinse [9] reported one of the earliest descriptions of fetal RVT in 1986, and a few additional cases have been described more recently [2,6,8]. Some authors suggested an increased incidence of this condition [1]; however, this may be a reflection of ascertainment bias based on improved ultrasonographic techniques and resolution.…”

“…We excluded 46 papers in which the RVT was diagnosed postnatally. Thus, 21 articles describing 22 cases of prenatally diagnosed RVT were included in the present study [2,3,6,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. Of these pregnancies, 19 were singleton and 3 were twin pregnancies.…”

“…Of these pregnancies, 19 were singleton and 3 were twin pregnancies. In the twin cases, only 1 twin was affected by fetal RVT and the other twin was normal [2,6,20]. …”

“…However, several risk factors are associated with this uncommon fetal condition, including maternal diabetes mellitus (type 1, type 2 or gestational), perinatal asphyxia, dehydration, polycythemia, cyanotic heart disease, antenatal corticosteroid therapy and coagulation abnormalities [6,7]. RVT can be unilateral or bilateral, and, even in severe cases, the thrombus can extend into the inferior vena cava (IVC) [8].…”