Large fetal intra‐abdominal umbilical vein varix: Antenatal sonographic diagnosis and follow‐up

Gowda, Sunil; Chakkalakkoombil, Sunitha Vellathussery; Bharathi, S. Vijayakumar; Barathi, Deepak

doi:10.1111/jog.14045

Cited by 7 publications

(11 citation statements)

References 14 publications

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“…La evaluación Doppler color detecta el flujo venoso en su interior y permite diferenciarlo de otras estructuras sonolucentes, como quiste de colédoco o del uraco (10) . Además, el trazado espectral también contribuye a confirmar el patrón de flujo venoso dentro de la lesión (2) .…”

Section: Discussionunclassified

“…La resultante perinatal depende de la edad gestacional al momento de la detección, malformaciones asociadas y características del flujo intralesional. A mayor diámetro de la lesión, mayor es el riesgo de trombosis (2) . Además, el flujo turbulento bidireccional en el segmento dilatado ha sido descrito en aproximadamente 50% de los casos (4,15) .…”

Section: Discussionunclassified

“…Las varices intraabdominales de la vena umbilical fetal están representadas por la dilatación aneurismática focal desde su entrada en la pared abdominal hasta su desembocadura en el sistema portal fetal (1) . Si bien son poco comunes, (representan solo el 4% de las malformaciones del cordón umbilical), son fácilmente detectables debido a los avances técnicos en las técnicas de diagnóstico por imágenes (ecografía convencional y Doppler color) (2) . El significado e importancia sobre la evolución fetal y neonatal de esta malformación vascular son desconocidos en la actualidad.…”

Section: Introductionunclassified

“…El significado e importancia sobre la evolución fetal y neonatal de esta malformación vascular son desconocidos en la actualidad. Aunque los casos detectados de forma aislada tienen una resultante perinatal razonablemente favorable, diferentes estudios asocian su presencia con anomalías cromosómicas, anatómicas o estructurales y aumento de la frecuencia de resultados perinatales adversos (2,3) . Se presenta un caso de diagnóstico prenatal de várice intraabdominal de la vena umbilical fetal.…”

Section: Introductionunclassified

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Diagnóstico prenatal de várice intraabdominal de la vena umbilical fetal

Torres-Cepeda

Rondón-Tapía

2021

Rev peru ginecol obstet.

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Las varices intraabdominales de la vena umbilical fetal son entidades poco comunes caracterizadas por la dilatación aneurismática focal. Representan aproximadamente 4% de las anomalías del cordón umbilical y se cree que son una anomalía del desarrollo más que una malformación congénita. Su importancia clínica aún no ha sido establecida claramente. El diagnóstico prenatal es realizado por ecografía convencional en la cual la lesión aparece como una estructura quística redonda o fusiforme dentro del abdomen fetal. Además, es útil para establecer el diámetro y la presencia de otras anomalías fetales asociadas. La evaluación Doppler permite identificar el tipo de flujo intralesional. El pronóstico perinatal es favorable cuando es identificada como un hallazgo aislado. No obstante, en aquellos casos asociados a otras alteraciones anatómicas / estructurales, la resultante fetal y neonatal es variable. Se presenta un caso de diagnóstico prenatal de varice intraabdominal de la vena umbilical fetal.

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Section: Discussionunclassified

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Diagnóstico prenatal de várice intraabdominal de la vena umbilical fetal

Torres-Cepeda

Rondón-Tapía

2021

Rev peru ginecol obstet.

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“…The umbilical vein varix (UVV) is relatively rare, with an overall incidence of 0.4%-1.1% [33][34][35][36]. Dilatation of the umbilical vein in the abdominal cavity of the fetus, known as intra-abdominal umbilical vein varix (Fig.…”

Section: Varixmentioning

confidence: 99%

Current Perspectives on Umbilical Cord Abnormalities Including Blood Flow Parameters Based on Ultrasound Observations

Xue¹,

Liu²,

Wang³

et al. 2022

Molecular &Amp; Cellular Biomechanics

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The umbilical cord is a vital structure between the fetus and placenta for the growth and well-being of the fetus. Although the umbilical cord may be the only organ that dies at the beginning of life, it is one of the most important parts of the feta-placental unit and plays a role in determining how life begins. In general, the prenatal examination of the umbilical cord is limited to the observation of the number of vessels and the evaluation of umbilical artery blood flow parameters. Pathologists have done more research on the morphological characteristics of the umbilical cord and linked them to perinatal outcomes. The introduction of advanced imaging technology makes it possible to study the characteristics of fetal umbilical cord from early to late gestation. Many studies have shown that the changes of umbilical cord structure may be related to pathological conditions, such as preeclampsia, fetal growth restriction. Prenatal morphometric umbilical cord characteristics and arterial blood flow parameters in normal and pathologic conditions are discussed in this review.

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Isolated fetal umbilical vein varix and the association with intrauterine fetal death and fetal growth restriction: A systematic review, meta‐analysis, and nested retrospective cohort study

Koorn,

Heinrich,

Nelissen

et al. 2024

Prenatal Diagnosis

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ObjectivesTo assess the risk of intrauterine fetal death (IUFD) and fetal growth restriction (FGR) in fetuses with an isolated fetal intra‐abdominal umbilical vein varix (i‐FIUVV).MethodsA retrospective cohort study combined with a systematic review and meta‐analysis of the literature was performed. In the retrospective cohort study, all singleton fetuses with an i‐FIUVV in the fetal medicine units of the Amsterdam UMC (between 2007 and 2023) were analyzed. The primary outcome measures were IUFD and FGR. The sample proportions of IUFD and FGR were depicted as risk percentages. The IUFD proportion was compared to the regional reference population and the FGR proportion was compared to the reported proportions in Europe. The secondary outcome measures were gestational age at diagnosis, initial and maximal FIUVV diameter, fetal monitoring in pregnancy, turbulent flow in the varix, thrombus formation in the varix, induction of labor, gestational age at birth, and birthweight centile. The proportion of fetuses with a birthweight below the 10th centile was compared with that of the regional reference population. The systematic review included all cases from eligible literature published between 2007 and 2023 supplemented by the data of our retrospective cohort study. In the systematic review and meta‐analysis, the pooled proportions of IUFD and FGR were assessed in fetuses with i‐FIUVV.ResultsThe retrospective cohort included 43 singletons with an i‐FIUVV. The IUFD risk was 0% [Confidence Interval, CI: 0%–8.2%], which did not differ significantly from 0.3% in the reference population, p = 1.0. The risk of FGR was 16.3% [CI: 6.8%–30.7%] in the studied population, which is higher than the reported incidence of FGR in Europe ranging from 5%–10%. The proportion of fetuses with birthweights below the 10th centile was higher in our cohort compared with the reference population (23.3 vs. 9.9%, p < 0.01). The systematic review included 12 articles, three abstracts, and our current cohort. In total, 513 cases with an i‐FIUVV were included. The pooled risk was 0.4% [CI: 0.1%–1.7%] for IUFD and 5.2% [CI: 1.1%–21.3%] for FGR. The mean gestational age at birth did not exceed 39 weeks in neither the cohort (38.7 weeks) nor the pooled literature (37.6 weeks).ConclusionAn i‐FIUVV in singletons is not associated with an increased IUFD risk up to 39 weeks of gestation but is possibly associated with FGR. The incidence of FGR in our cohort was higher than in the pooled literature (16.3% vs. 5%) but FGR definitions in the included studies varied. The proportion of birthweights below the 10th percentile in our cohort was significantly higher than in the reference group. Thus, based on these findings, we suggest conducting sonographic growth assessments while simultaneously assessing the i‐FIUVV. No further monitoring and follow‐up are indicated up to 39 weeks of gestation. After 39 weeks of gestation, data on fetuses with i‐FIUVV and their outcomes are lacking.

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Large fetal intra‐abdominal umbilical vein varix: Antenatal sonographic diagnosis and follow‐up

Cited by 7 publications

References 14 publications

Diagnóstico prenatal de várice intraabdominal de la vena umbilical fetal

Diagnóstico prenatal de várice intraabdominal de la vena umbilical fetal

Current Perspectives on Umbilical Cord Abnormalities Including Blood Flow Parameters Based on Ultrasound Observations

Isolated fetal umbilical vein varix and the association with intrauterine fetal death and fetal growth restriction: A systematic review, meta‐analysis, and nested retrospective cohort study

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