Navarro GT, Bravo AC, Pérez Fernández-Pacheco R, Gámez AF, de León- Luis J

Language: Spanish
References: 12
Page: 504-509
PDF size: 252.24 Kb.

ABSTRACT

Background: Increased number of cardiovascular disorders diagnosed prenatally is not a consequence of a spontaneous growing, but of the advance in echographic techniques, specifically, high-resolution echography, color Doppler, a higher knowledge and systematization in exploring fetal anatomy.
Objective: To describe the sonographic findings and perinatal outcomes in cases with prenatal ultrasound diagnosis of intraabdominal umbilical vein varix (UVV).
Methods: Retrospective study of cases with prenatal ultrasound diagnosis of UVV. The diagnosis is performed at the level of the abdominal circumference when the diameter of the vessel is above the established parameters for a certain gestational age. Variables concerning maternal-fetal features, ultrasound findings and perinatal outcomes of affected cases are described.
Results: During the period August 2008 to August 2012 14 cases of intra-abdominal UVV were diagnosed in our center with a mean gestational age at diagnosis of 29 weeks. Of the 14 cases, 35% had associated anomalies, mostly cardiovascular anomalies. No chromosomal defects were detected. Perinatal outcomes in newborns were favorable, with mean gestational age at delivery of 38 weeks. Only one case of monochorionic-monoamniotic twin pregnancy required preterm elective termination secondary to a twin to twin transfusion syndrome.
Conclusion: Prenatal diagnosis of intra-abdominal UVV should be followed by further studies given its possible association with other anomalies, chromosomal defects and cases of stillbirth. However, isolated cases of UVV, representing a majority, often evolve favorably with few complications.

REFERENCES

1. Yagel S, Kivilevitch Z, Cohen SM, Valsky DV, et al. The fetal venous system, part I: normal embryology, anatomy, hemodynamics, ultrasound evaluation and Doppler investigation. Ultrasound Obstet Gynecol 2010; 35: 741-750. DOI 10.1002/uog.7618.

2. Weissmann-Brenner A, Simchen MJ, Moran O, Kassif E, et al. Isolated fetal umbilical vein varix-prenatal sonographic diagnosis and suggested management. Prenat Diagn 2009; 29: 229-233. DOI 10.1002/pd.2219.

3. Byers BD, Goharkhay N, Mateus J, Ward KK, et al. Pregnancy outcome after ultrasound diagnosis of fetal intra-abdominal umbilical vein varix. Ultrasound Obstet Gynecol 2009;33: 282-286. DOI 10.1002/ uog.6233.

4. Fung TY, et al. Fetal intra-abdominal umbilical vein varix: what is the clinical significance? Ultrasound Obstet Gynecol 2005; 25: 149-154. DOI 10.1002/ uog.1815.

5. Mankuta D, et al. Pomp. Isolated fetal intra-abdominal umbilical vein varix: clinical importance and recommendations. J Ultrasound Med 2011; 30: 273-276. DOI 30/2/273 [pii].

6. Mahony BS, et al. Varix of the fetal intra-abdominal umbilical vein: comparison with normal. J Ultrasound Med 1992; 11: 73-76.

7. White SP, Kofinas A. Prenatal diagnosis and management of umbilical vein varix of the intra-amniotic portion of the umbilical vein. J Ultrasound Med 1994; 13: 992-994.

8. Sepulveda W, et al. Fetal prognosis in varix of the intrafetal umbilical vein. J Ultrasound Med 1998; 17: 171-175.

9. Allen SL, et al. Thrombosing umbilical vein varix. J Ultrasound Med 1998; 17: 189-192.

10. Zalel Y, et al. Varix of the fetal intra-abdominal umbilical vein: prenatal sonographic diagnosis and suggested in utero management. Ultrasound Obstet Gynecol 2000; 16: 476-478.

11. Viora E, et al. Thrombosis of umbilical vein varix. Ultrasound Obstet Gynecol 2002; 19: 212-213.

12. Ipek A, et al. Prenatal diagnosis of fetal intra-abdominal umbilical vein varix: report of 2 cases. J Clin Ultrasound 2008; 36: 48-50.