Abstract:Umbilical vein varices are rare umbilical cord anomalies that typically occur intra-abdominally. Extra-abdominal umbilical vein varices are exceedingly rare and usually diagnosed postnatally on gross pathologic examination. Umbilical vein varices have been associated with increased risk of fetal anemia, cardiac abnormalities, and intrauterine fetal demise. This case report discusses a patient who presented with a massive extra-abdominal umbilical vein varix, whose infant was ultimately delivered due to fetal d… Show more
“…Umbilical varix is defined when the caliber is greater than 9 mm or with a ratio of >50% between the dilated and a more distal normal intraabdominal portion of the vein (Figure 8). [180][181][182] The incidence of this condition is relatively rare, occurring between 0.4 and 1.1/1000 deliveries and is associated with additional fetal anomalies in one-third of cases, [183][184][185]…”
Section: Varixmentioning
confidence: 99%
“…Umbilical varix is defined when the caliber is greater than 9 mm or with a ratio of >50% between the dilated and a more distal normal intra-abdominal portion of the vein ( Figure 8 ). 180–182 Figure 8 Fetal intra-abdominal varix at 24 and 5/7 weeks’ gestation. Upper panel: Real-time ultrasound depicting the intra-abdominal aneurysmal dilatation of the umbilical vein.…”
Section: Functional Disorders Of the Umbilical Cordmentioning
The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton's jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl's anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.
“…Umbilical varix is defined when the caliber is greater than 9 mm or with a ratio of >50% between the dilated and a more distal normal intraabdominal portion of the vein (Figure 8). [180][181][182] The incidence of this condition is relatively rare, occurring between 0.4 and 1.1/1000 deliveries and is associated with additional fetal anomalies in one-third of cases, [183][184][185]…”
Section: Varixmentioning
confidence: 99%
“…Umbilical varix is defined when the caliber is greater than 9 mm or with a ratio of >50% between the dilated and a more distal normal intra-abdominal portion of the vein ( Figure 8 ). 180–182 Figure 8 Fetal intra-abdominal varix at 24 and 5/7 weeks’ gestation. Upper panel: Real-time ultrasound depicting the intra-abdominal aneurysmal dilatation of the umbilical vein.…”
Section: Functional Disorders Of the Umbilical Cordmentioning
The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton's jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl's anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.
“…We used Lasso regression analysis and Cox risk regression analysis to identify five CRLs (AC005332.6, AC090114.2, LINC00857, LINC02041, and AL117382.1) that were shown to be independent prognostic variables for PAAD and correctly classified PAAD patients into two separate prognosis categories. Evidence suggests that AC005332.6, AC090114.2, and LINC02041 may serve as prognostic markers for many cancers, including pancreatic cancer [ 42 , 53 , 54 , 55 , 56 ]. Through a ceRNA-mediated mechanism, LINC00857 promotes the growth and invasion of pancreatic cancer cells [ 51 ].…”
In terms of mortality and survival, pancreatic cancer is one of the worst malignancies. Known as a unique type of programmed cell death, cuprotosis contributes to tumor cell growth, angiogenesis, and metastasis. Cuprotosis programmed-cell-death-related lncRNAs (CRLs) have been linked to PAAD, although their functions in the tumor microenvironment and prognosis are not well understood. This study included data from the TCGA-PAAD cohort. Random sampling of PAAD data was conducted, splitting the data into two groups for use as a training set and test set (7:3). We searched for differentially expressed genes that were substantially linked to prognosis using univariate Cox and Lasso regression analysis. Through the use of multivariate Cox proportional risk regression, a risk-rating system for prognosis was developed. Correlations between the CRL signature and clinicopathological characteristics, tumor microenvironment, immunotherapy response, and chemotherapy sensitivity were further evaluated. Lastly, qRT-PCR was used to compare CRL expression in healthy tissues to that in tumors. Some CRLs are thought to have strong correlations with PAAD outcomes. These CRLs include AC005332.6, LINC02041, LINC00857, and AL117382.1. The CRL-based signature construction exhibited outstanding predictive performance and offers a fresh approach to evaluating pre-immune effectiveness, paving the way for future studies in precision immuno-oncology.
“…Umbilical vein varix can be seen in the form of intraabdominal umbilical vein varix, extra-abdominal umbilical vein varix, and umbilical vein aneurysm [18,19], among which the intra-abdominal varix is the most prevalent while the extra-abdominal varix and umbilical vein aneurysm are rare [20]. Normally, the internal diameter of the intraabdominal umbilical vein in normal fetuses grows proportionately with the increase of gestational age.…”
Background: Normally, fetal umbilical vein (UV) starts from the capillary network in the chorionic villus and accompanies the umbilical artery (UA). After leaving the placenta, it courses along within the umbilical cord. As the embryo develops, the proximal segment of both the right and left umbilical veins obliterate, and the distal end of the left umbilical vein enters the liver. The microvessels passing through the liver gradually merge and communicate with the hepatic sinus to form the ductus venosus, which then drains into the inferior vena cava (IVC). UV anatomical and morphological abnormalities in complex and variable forms often lead to poor fetal prognosis. In light of this, a thorough prenatal ultrasound providing detailed information on UV abnormalities is potentially clinically significant. Methods: The sonographic features and clinical data of fetuses diagnosed with abnormal umbilical vein anatomy and morphology by antenatal ultrasonography from January 2016 to December 2021 in Sichuan Provincial Maternity and Child Health Care Hospital were retrospectively analyzed. Results: A total of 403 fetuses were included in the study. Among them, 318 cases were diagnosed with intrahepatic persistent right umbilical vein, and 44 cases experienced intracardiac malformations, 34 cases with extracardiac malformations, and 14 cases with both intra-and extracardiac malformations. Three cases had double umbilical veins; 1 case with intracardiac malformation and 1 case with extracardiac malformation. Eighty cases were diagnosed with umbilical vein varix (manifested as intra-or extra-abdominal vein varix or umbilical vein aneurysm); 2 cases with intracardiac malformations and 11 cases with extracardiac malformations. Two cases were diagnosed with umbilical vein stenosis, with neither of them combined with other malformations. Among the 403 fetuses, 86 received genetic testing with 8 of them confirmed with chromosomal abnormalities and the remaining 78 being normal. Of the 8 cases, 7 were diagnosed with persistent right umbilical vein (PRUV) and 1 had umbilical vein stenosis. As related to pregnancy outcomes, 386 fetuses had no obvious abnormalities being observed during the subsequent 2 years' follow-up and 17 cases were terminated due to serious malformations. Conclusions: Antenatal ultrasound assists in the accurate diagnosis of anatomical and morphological abnormalities of the umbilical vein. For cases with no other malformations or chromosomal abnormalities, a better prognosis can be expected and careful follow-up is required, whereas for those with severe malformations or chromosomal abnormalities, the prognosis is often poor. Prenatal ultrasound should provide careful examination to determine whether the fetal umbilical vein has normal anatomy and morphology, thereby supporting better prenatal outcomes.
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