Obstet Gynecol Sci.  2014 May;57(3):181-186. 10.5468/ogs.2014.57.3.181.

Clinical characteristics and outcomes of antenatal fetal intra-abdominal umbilical vein varix detection

• Lee SW
• Kim MY
• Kim JE
• Chung JH
• Lee HJ
• Yoon JY

• KMID: 1704423
• DOI: http://doi.org/10.5468/ogs.2014.57.3.181

Abstract

OBJECTIVE
This study reviewed clinical characteristics of fetal intra-abdominal umbilical vein (FIUV) varices that were detected during antenatal ultrasound examinations.
METHODS
Between January 2006 and January 2012, 121 cases of FIUV varices were detected and 7 cases were lost to follow-up. We retrospectively reviewed the medical records of 114 patients and neonates.
RESULTS
From a total 96,553 ultrasound examinations in 43,995 pregnancies, 121 cases of FIUV varices were identified (2.8 per 1,000 pregnancies). Gestational age at diagnosis was 32.0 +/- 2.9 weeks (range, 20.1-36.3 weeks), the mean diameter of the FIUV varix was 12.6 +/- 2.1 mm (range, 8.0-21.0 mm) at initial diagnosis and the mean maximal diameter was 13.1 +/- 2.3 mm (range, 8.0-21.0 mm) during follow-up. The most severe pregnancy complications included one case of intrauterine fetal death and another case of fetal hydrops. Associated fetal anomalies (n = 11, 9.6%) detected by ultrasonography included bilateral renal pelvis dilatation, ventriculomegaly, cryptorchidism, incomplete renal duplication and pulmonary sequestration. A total of 104 cases (91.2%) were delivered at term and 10 cases (8.8%) were preterm deliveries before 37 weeks of gestation.
CONCLUSION
FIUV varices that are not associated with fetal anomalies based on ultrasound examination during prenatal care have favorable pregnancy outcomes. Nevertheless, close fetal monitoring is recommended to decrease perinatal complications.

Keyword

Antenatal ultrasound; Umbilical veins; Varicose veins

MeSH Terms

Bronchopulmonary Sequestration
Cryptorchidism
Diagnosis
Dilatation
Female
Fetal Death
Fetal Monitoring
Follow-Up Studies
Gestational Age
Humans
Hydrops Fetalis
Infant, Newborn
Kidney Pelvis
Lost to Follow-Up
Male
Medical Records
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Prenatal Care
Retrospective Studies
Ultrasonography
Umbilical Veins*
Varicose Veins*

Figure

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  Fig. 1 (A) Transverse view of the lower fetal abdomen showing an umbilical vein varix that was approximately 16.9 mm at 33 weeks of gestation. (B) Color Doppler shows some turbulence in the intravascular area and differentiates from other cystic lesions. BL, bladder; VAR, fetal umbilical vein varix.

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