Prenatal diagnosis of fetal intra-abdominal umbilical vein varix

Objective

Fetal intra-abdominal umbilical vein varix (FIUV) is aneurysmatic dilatation of umbilical vein, and constitutes approximately 4% of umbilical cord abnormalities. FIUV varix is defined as a condition in which the diameter of umbilical vein is above 9 mm.

Case(s)

In the detailed anatomy scan of a 26 year-old patient having second pregnancy, varicose enlargements were detected in the umbilical vein of the fetus (FİGURE 1); the diameter of umbilical vein was measured as 10.2 mm (FİGURE 2). Varicose enlargement with a diameter of 18 mm was found under the connection point of umbilical vein to the abdomen in the fetus (FİGURE 3). Fetal growth retardation was observed after 32nd week of pregnancy. When her last menstrual period was taken into account, five-week intrauterine growth retardation was present in 39th week of pregnancy. The patient underwent cesarean operation. It was observed in the ultrasound and Doppler ultrasonography examinations carried out in the 7th day after the delivery that venous structures in the abdomen of the newborn were normal.

Results

FIUV is a rare complication whose incidence rate has been found to be 1/2300; it constitutes 4% of approximately all umbilical cord malformations. Although pregnancy prognosis is stated to be generally fine in those patients, it is also indicated that FIUV findings may be used as an indicator for abnormality scan because of the risk of concomitant fetal abnormalities. In our case, no concomitant abnormality was detected in fetal scan. Intrauterine growth retardation was found in the follow-ups of the pregnancy.

Conclusion

The prognosis of FIUV is generally fine. In most cases, close sonographic monitoring is considered to be sufficient until the term and the termination of the pregnancy is not thought to be necessary. The timing of delivery may vary according to the progressing complications.

Keywords

Umbilical vein, varix, prenatal diagnosis

	File/Dsecription
	Figure 1 The diameter of umbilical vein was measured as 10.2 mm.
	Figure 2 The diameter of varicose enlargement was measured as 18 mm, under the connection point of umbilical vein to the abdomen.
	Figure 3 Ultrasound and Doppler ultrasonography examinations at after the delivery that venous structures in the abdomen of the newborn were normal.