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

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주제분류산부인과학

초록

ObjectiveThis study reviewed clinical characteristics of fetal intra-abdominal umbilical vein (FIUV) varices that were detected during antenatal ultrasound examinations. MethodsBetween 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. ResultsFrom 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. ConclusionFIUV 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.

Abstract

ObjectiveThis study reviewed clinical characteristics of fetal intra-abdominal umbilical vein (FIUV) varices that were detected during antenatal ultrasound examinations. MethodsBetween 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. ResultsFrom 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. ConclusionFIUV 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.

참고문헌 (10)

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  4. Mahony BS, "Varix of the fetal intra-abdominal umbilical vein: comparison with normal", J Ultrasound Med, 11, pp.73~76 (1992)
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  6. Rahemtullah A, "Outcome of pregnancy after prenatal diagnosis of umbilical vein varix", J Ultrasound Med, 20, pp.135~139 (2001)
  7. Byers BD, "Pregnancy outcome after ultrasound diagnosis of fetal intra-abdominal umbilical vein varix", Ultrasound Obstet Gynecol, 33, pp.282~286 (2009)
  8. Weissmann-Brenner A, "Isolated fetal umbilical vein varix:prenatal sonographic diagnosis and suggested management", Prenat Diagn, 29, pp.229~233 (2009)
  9. Fung TY, "Fetal intra-abdominal umbilical vein varix: what is the clinical significance?", Obstet Gynecol, 25, pp.149~154 (2005)
  10. Zalel Y, "Varix of the fetal intra-abdominal umbilical vein: prenatal sonographic diagnosis and suggested in utero management", Ultrasound Obstet Gynecol, 16, pp.476~478 (2000)

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