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Kaymak D, Madazli R. Evaluation of the type of fetal umblical-portal anastomosis in late-onset fetal growth restriction: A case-control study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:353-358. [PMID: 38214396 DOI: 10.1002/jcu.23636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/16/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE To evaluate the type of umbilical-portal anastomosis in late-onset fetal growth restriction (LO-FGR) and appropriate for gestational age (AGA) fetuses. To investigate the impact of the type of umbilical-portal anastomosis on the adverse outcomes in LO-FGR. METHOD This study observed 150 pregnancies with AGA fetuses and 62 pregnancies with fetuses with LO-FGR. In each case, the point of reference for measuring the abdominal circumference was established. The type of umbilical-portal anastomosis was evaluated as T-shaped, X-shaped, and H-shaped according to the shape of main portal vein and portal sinus. Incidences of the type of umbilical-portal anastomosis in AGA and LO-FGR fetuses were evaluated. RESULTS T-shaped anastomosis was the most common (56.7%) in the AGA group and X-shaped (66.1%) in the LO-FGR group. In LO-FGR, T-shape anastomosis was significantly lower and X-shape anastomosis was significantly higher than AGA (p < 0.001). X-shaped anastomosis was associated with LO-FGR and the RR was 2.3 (95% CI 1.5-3.6; p < 0.001). Incidences of admission to NICU and emergency C/S for fetal distress were higher in fetuses with X -shaped anastomosis in the LO-FGR (p < 0.05). CONCLUSION X-shaped umbilical-portal anastomosis have a prognostic significance in LO-FGR fetuses.
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Affiliation(s)
- Didem Kaymak
- Department of Obstetrics and Gynecology, Agri Education and Research Hospital, Agri, Turkey
| | - Riza Madazli
- Cerrahpasa Medical Faculty, Department of Obstetrics and Gynecology, Istanbul University-Cerrahpasa, Istanbul, Turkey
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2
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Sekiguchi M, Mukai T, Shitara Y, Kashima K, Seyama T, Kumasawa K, Takahashi N. Case report: A case of fetal umbilical vein varix presenting disseminated intravascular coagulation, polycythemia, and neonatal hepatitis in an extremely low birth weight infant. Front Pediatr 2023; 11:1154820. [PMID: 37063663 PMCID: PMC10098078 DOI: 10.3389/fped.2023.1154820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/14/2023] [Indexed: 04/18/2023] Open
Abstract
Reports on the clinical course of fetal umbilical vein varix in premature infants are limited. We report a case of an extremely low body weight infant with intra-abdominal umbilical vein varix who developed disseminated intravascular coagulation, polycythemia, and hyperbilirubinemia after birth; late-onset neonatal hepatitis; and fetal thrombotic vasculopathy confirmed by placental histopathology. Ultrasonography after birth showed a dilated portion of the umbilical vein at the hepatic hilum with thrombi inside. We speculate that the umbilical vein varix caused the fetal thrombotic vasculopathy, and the presence of umbilical vein varix and fetal thrombotic vasculopathy in combination with prematurity caused coagulopathy, polycythemia, hyperbilirubinemia, and hepatitis. Despite the favorable outcomes reported in the literature, premature infants with umbilical vein varix may require careful observation and management for coagulopathy and late-onset hepatitis. Furthermore, placental histopathology could aid in the understanding of various clinical outcomes in infants with umbilical vein varices.
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Affiliation(s)
- Mariko Sekiguchi
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Takeo Mukai
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
- Correspondence: Takeo Mukai
| | - Yoshihiko Shitara
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Kohei Kashima
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Takahiro Seyama
- Department of Obstetrics and Gynecology, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiichi Kumasawa
- Department of Obstetrics and Gynecology, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoto Takahashi
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
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3
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Bohîlțea RE, Dumitru A, Vlădăreanu R, Pleș L, Georgescu TA, Petrescu IA, Munteanu O. Ultrasound Pitfalls in a Complex Fetal Cardiac Malformation—Case Report of a New Arteriovenous Central Communication. Diagnostics (Basel) 2021; 11:diagnostics11122398. [PMID: 34943634 PMCID: PMC8699901 DOI: 10.3390/diagnostics11122398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/18/2021] [Accepted: 12/18/2021] [Indexed: 11/22/2022] Open
Abstract
Cardiac and cardiovascular malformations are of real interest in terms of definition, epidemiology, and means of early diagnosis by imaging. Although ultrasound examination reaches exceptional performance nowadays, unusual pathologies are still exposed to the risk of either incorrect acquired image or misinterpretation by the specialist in a routine scan. Herein, we present a case of a 20-week-old fetus (from an apparently low-risk pregnancy) with complex cardiac and vascular abnormalities, including an arteriovenous malformation along with ventricular septal defect, ductal coarctation of the aorta, aneurysm of a brachiocephalic vein, and dilation of the entire neck and upper mediastinum venous system, and the limitations that were encountered in the process of diagnosis and management of the case.
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Affiliation(s)
- Roxana Elena Bohîlțea
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
- Correspondence: (R.E.B.); (L.P.); (I.-A.P.)
| | - Adrian Dumitru
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.D.); (T.A.G.)
| | - Radu Vlădăreanu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Liana Pleș
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Sf Ioan Hospital-Bucur Maternity, 040294 Bucharest, Romania
- Correspondence: (R.E.B.); (L.P.); (I.-A.P.)
| | - Tiberiu Augustin Georgescu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.D.); (T.A.G.)
| | - Ioan-Andrei Petrescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence: (R.E.B.); (L.P.); (I.-A.P.)
| | - Octavian Munteanu
- Department of Anatomy, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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4
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Haga M, Itoh K, Horikoshi T, Namba F, Kabe K. Severe Consumptive Coagulopathy in an Extremely-Low-Birth-Weight Infant with Intra-Abdominal Umbilical Vein Varix: A Case Report. AJP Rep 2021; 11:e76-e79. [PMID: 34055464 PMCID: PMC8159582 DOI: 10.1055/s-0041-1727288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/15/2021] [Indexed: 10/27/2022] Open
Abstract
Recent studies have shown favorable outcomes for intra-abdominal umbilical vein varices (IUVVs) in term neonates who have no other complications. Little is known, however, about the prognosis of IUVVs in preterm neonates. We encountered a case of IUVV in an extremely low-birth-weight infant who developed severe consumptive coagulopathy after birth. The patient's coagulation test normalized as the varix spontaneously obstructed. Although life-threatening hemorrhagic complications were avoided, a cerebellum hemorrhage was found in the brain magnetic resonance imaging at the term-equivalent age. In a literature survey, coagulopathy was reported in 4 out of 15 infants with IUVVs born before 34 weeks of gestation, including our present case. Preterm infants with IUVVs may develop coagulopathy because of the prematurity of their coagulation-fibrinolysis systems. Attention should be given to the coagulation status of preterm neonates with IUVVs.
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Affiliation(s)
- Mitsuhiro Haga
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Kanako Itoh
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Tsuguhiro Horikoshi
- Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Kazuhiko Kabe
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
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5
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Toscano P, Saccone G, Di Meglio L, Di Meglio L, Mastantuoni E, Riccardi C, Raffone A, Zullo F, Locci M, Di Meglio A. Intrahepatic persistent fetal right umbilical vein: a retrospective study. J Matern Fetal Neonatal Med 2019; 34:4025-4028. [PMID: 31842642 DOI: 10.1080/14767058.2019.1702954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: To appraise the incidence and value of intrahepatic persistent right umbilical vein (PRUV).Methods: This was a single-center study. Records of all women with a prenatal diagnosis of intrahepatic PRUV were reviewed. The inclusion criteria were women with gestational age greater than 13 weeks of gestation. Exclusion criteria were fetuses with situs abnormalities, due to the hepatic venous ambiguity, and extrahepatic PRUV. The primary outcome was the incidence of intrahepatic PRUV in our cohort. The secondary outcomes were associated malformations.Results: 219/57,079 cases (0.38%) of intrahepatic PRUV were recorded. The mean gestational age at diagnosis was 21.8 ± 2.9 weeks of gestations. PRUV was isolated in the 76.7%, while in 23.3% was associated with other major or minor abnormalities. The most common associated abnormalities were cardiovascular abnormalities (8.7%), followed by genitourinary abnormalities (6.4%), skeletal abnormalities (4.6%), and central nervous system abnormalities (4.1%). Within the cardiovascular abnormalities, the most common one was ventricular septal defect (six cases).Conclusion: In most cases PRUV is an isolated finding. Associated minor or major malformations are presented in the 23.3% of the cases, so this finding should prompt detailed prenatal assessment of the fetus, with particular regard to cardiovascular system.
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Affiliation(s)
- Paolo Toscano
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Lavinia Di Meglio
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Letizia Di Meglio
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Enrica Mastantuoni
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Carla Riccardi
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Aniello Di Meglio
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", Naples, Italy.,Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
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Grin L, Shenhav S, Elasbah A, Rabinovich M, Sofer H, Anteby EY, Zohav E. Is umbilical vein varix associated with changes in cerebroplacental ratio? J Matern Fetal Neonatal Med 2018; 33:162-166. [PMID: 29888988 DOI: 10.1080/14767058.2018.1487943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objective: We aimed to review a single-center experience in follow-up and management of fetuses with umbilical vein varix (UVV) and to assess the effect of UVV on fetal Doppler parameters.Methods: We reviewed retrospectively maternal antenatal records, delivery records, and newborn records to identify cases of UVV. Further, we retrospectively compared 25 fetuses with isolated UVV and available cerebroplacental ratio (CPR) analysis with 75 matched controls.Results: We identified 67 cases of UVV. The median gestational age (GA) at diagnosis was 34 weeks (range: 26-41 weeks). The average diameter of UVV at diagnosis was 10.1 mm (range: 9-14 mm). The median GA at delivery was 36 + 6 (range: 33-41 weeks), with an average birth weight of 2918 g (range: 1278-4140 g). There was a single case of intrauterine death at 35 weeks. CPR was 2.13 ± 0.62 in isolated UVV group compared with 1.84 ± 0.61 in the control group (p < .05). Other Doppler parameters did not differ between fetuses with UVV compared with controls.Conclusions: CPR was significantly increased in the UVV group compared with control fetuses. This finding suggests that UVV is not associated with chronic fetal oxygen deprivation; it, therefore, may contribute to our understanding of the pathophysiology explaining abnormal pregnancy outcome in cases with UVV.
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Affiliation(s)
- Leonti Grin
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
| | - Simon Shenhav
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
| | - Ahmed Elasbah
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
| | - Mark Rabinovich
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
| | - Hadar Sofer
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
| | - Eyal Y Anteby
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
| | - Efraim Zohav
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkeon, Israel
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7
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Lei T, Xie HN, Feng JL. Prenatal diagnosis of four-vessel umbilical cord with supernumerary vein varix: A case report and literature review. J Obstet Gynaecol Res 2017; 43:1200-1204. [PMID: 28561938 DOI: 10.1111/jog.13324] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/15/2017] [Accepted: 02/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Ting Lei
- Department of Ultrasonic Medicine, Fetal Medical Centre; the First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
| | - Hong-Ning Xie
- Department of Ultrasonic Medicine, Fetal Medical Centre; the First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
| | - Jie-Ling Feng
- Department of Ultrasonic Medicine, Fetal Medical Centre; the First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
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8
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Ozek MA, Calis P, Bayram M, Karcaaltincaba D. Fetal intraabdominal umbilical vein varix: antenatal diagnosis and management. J Matern Fetal Neonatal Med 2017; 31:245-250. [DOI: 10.1080/14767058.2016.1278208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Murat Aykut Ozek
- Department of Obstetrics and Gynaecology, Gazi University School of Medicine, Ankara, Turkey
| | - Pinar Calis
- Department of Obstetrics and Gynaecology, Gazi University School of Medicine, Ankara, Turkey
| | - Merih Bayram
- Department of Obstetrics and Gynaecology, Gazi University School of Medicine, Ankara, Turkey
| | - Deniz Karcaaltincaba
- Department of Obstetrics and Gynaecology, Gazi University School of Medicine, Ankara, Turkey
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9
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Lide B, Lindsley W, Foster MJ, Hale R, Haeri S. Intrahepatic Persistent Right Umbilical Vein and Associated Outcomes: A Systematic Review of the Literature. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:1-5. [PMID: 26635256 DOI: 10.7863/ultra.15.01008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/27/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to provide a comprehensive review of the current data surrounding an intrahepatic persistent right umbilical vein in the fetus, including associated anomalies and outcomes, and to assist practitioners in counseling and management of affected pregnancies. We performed a MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Northern Light database search for articles reporting outcomes on prenatally diagnosed cases of a persistent right umbilical vein. Each article was independently reviewed for eligibility by the investigators. Thereafter, the data were extracted and validated independently by 3 investigators. A total of 322 articles were retrieved, and 16 were included in this systematic review. The overall prevalence of an intrahepatic persistent right umbilical vein was found to be 212 per 166,548 (0.13%). Of the 240 cases of an intrahepatic persistent right umbilical vein identified, 183 (76.3%) were isolated. The remaining cases had a coexisting abnormality, including 19 (7.9%) cardiac, 9 (3.8%) central nervous system, 15 (6.3%) genitourinary, 3 (1.3%) genetic, and 17 (7%) placental/cord (predominantly a single umbilical artery). In summary, a persistent right umbilical vein is commonly an isolated finding but may be associated with a coexisting cardiac defect in 8% of cases. Therefore, consideration should be given to fetal echocardiography in cases of a persistent right umbilical vein.
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Affiliation(s)
- Brianna Lide
- Texas A&M Health Science Center College of Medicine, Temple, Texas USA (B.L.); St David's North Austin Medical Center Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas USA (W.L., R.H., S.H.); and Texas A&M University, Medical Sciences Library, College Station, Texas USA (M.J.F.)
| | - William Lindsley
- Texas A&M Health Science Center College of Medicine, Temple, Texas USA (B.L.); St David's North Austin Medical Center Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas USA (W.L., R.H., S.H.); and Texas A&M University, Medical Sciences Library, College Station, Texas USA (M.J.F.)
| | - Margaret J Foster
- Texas A&M Health Science Center College of Medicine, Temple, Texas USA (B.L.); St David's North Austin Medical Center Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas USA (W.L., R.H., S.H.); and Texas A&M University, Medical Sciences Library, College Station, Texas USA (M.J.F.)
| | - Richard Hale
- Texas A&M Health Science Center College of Medicine, Temple, Texas USA (B.L.); St David's North Austin Medical Center Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas USA (W.L., R.H., S.H.); and Texas A&M University, Medical Sciences Library, College Station, Texas USA (M.J.F.)
| | - Sina Haeri
- Texas A&M Health Science Center College of Medicine, Temple, Texas USA (B.L.); St David's North Austin Medical Center Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas USA (W.L., R.H., S.H.); and Texas A&M University, Medical Sciences Library, College Station, Texas USA (M.J.F.).
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10
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De León-Luis J, Bravo C, Gámez F, Ortiz-Quintana L. Cardiovascular System Sonographic Evaluation Algorithm: A New Sonographic Algorithm for Evaluation of the Fetal Cardiovascular System in the Second Trimester. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:1271-1282. [PMID: 26112631 DOI: 10.7863/ultra.34.7.1271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the reproducibility and feasibility of the new cardiovascular system sonographic evaluation algorithm for studying the extended fetal cardiovascular system, including the portal, thymic, and supra-aortic areas, in the second trimester of pregnancy (19-22 weeks). METHODS We performed a cross-sectional study of pregnant women with healthy fetuses (singleton and twin pregnancies) attending our center from March to August 2011. The extended fetal cardiovascular system was evaluated by following the new algorithm, a sequential acquisition of axial views comprising the following (caudal to cranial): I, portal sinus; II, ductus venosus; III, hepatic veins; IV, 4-chamber view; V, left ventricular outflow tract; VI, right ventricular outflow tract; VII, 3-vessel and trachea view; VIII, thy-box; and IX, subclavian arteries. Interobserver agreement on the feasibility and exploration time was estimated in a subgroup of patients. The feasibility and exploration time were determined for the main cohort. Maternal, fetal, and sonographic factors affecting both features were evaluated. RESULTS Interobserver agreement was excellent for all views except view VIII; the difference in the mean exploration time between observers was 1.5 minutes (95% confidence interval, 0.7-2.1 minutes; P < .05). In 184 fetuses (mean gestational age ± SD, 20 ± 0.6 weeks), the feasibility of all views was close to 99% except view VIII (88.7%). The complete feasibility of the algorithm was 81.5%. The mean exploration time was 5.6 ± 4.2 minutes. Only the occiput anterior fetal position was associated with a lower frequency of visualization and a longer exploration time (P < .05). CONCLUSIONS The cardiovascular system sonographic evaluation algorithm is a reproducible and feasible approach for exploration of the extended fetal cardiovascular system in a second-trimester scan. It can be used to explore these areas in normal and abnormal conditions and provides an integrated image of extended fetal cardiovascular anatomy.
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Affiliation(s)
- Juan De León-Luis
- Department of Obstetrics and Gynecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain (C.B., F.G., L.O.Q., J.D.L.-L.); and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.).
| | - Coral Bravo
- Department of Obstetrics and Gynecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain (C.B., F.G., L.O.Q., J.D.L.-L.); and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.)
| | - Francisco Gámez
- Department of Obstetrics and Gynecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain (C.B., F.G., L.O.Q., J.D.L.-L.); and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.)
| | - Luis Ortiz-Quintana
- Department of Obstetrics and Gynecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain (C.B., F.G., L.O.Q., J.D.L.-L.); and Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gómez Ulla, Universidad de Alcalá de Henares, Madrid, Spain (C.B.)
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11
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Melcer Y, Wiener Y, Ben-Ami I, Levinsohn-Tavor O, Feldman N, Maymon R. The Triple Test Markers Profile Among Fetuses and Children Diagnosed With Umbilical Vein Varix. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2014. [DOI: 10.1177/8756479314543559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Umbilical vein varix (UVV) is defined as a focal enlargement of the umbilical vein and represents approximately 4% of fetal umbilical cord malformations. The reported neonatal outcome of fetuses with UVV varies widely due to its rarity, hence the small sample sizes of the case series in the literature. Earlier studies reported high fetal mortality, but more recent reports have demonstrated no association between UVV and intrauterine fetal death. A recent study has described a possible association between UVV diagnosed prenatally and child developmental delay. The present study of fetuses with UVV was done to evaluate and compare the levels of triple test serum biomarkers used for Down syndrome screening (human chorionic gonadotropin, α-fetoprotein, and unconjugated estriol) between a group of fetuses with uneventful obstetric outcome versus a subgroup of children with developmental delay.
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Affiliation(s)
- Yaakov Melcer
- Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yifat Wiener
- Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ido Ben-Ami
- Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Orna Levinsohn-Tavor
- Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Noa Feldman
- Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Ben Brahim F, Hazelzet T, Cohen L, Durand I, Blanc J, Barre E, Daudruy MB, David N. Aberrant drainage of the umbilical vein into the coronary sinus without ductus venosus agenesis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:535-542. [PMID: 24567466 DOI: 10.7863/ultra.33.3.535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We describe a case series of 4 fetuses with ectopic connections of the ductus venosus to the coronary sinus detected prospectively between August 2011 and February 2012 in 2 congenital cardiologic centers. An enlarged coronary sinus alerted the sonographer. Fetal echocardiography showed ectopic connection of the ductus venosus in an enlarged coronary sinus in all 4 cases. To our knowledge, this anatomic form of ectopic umbilical vein drainage has not previously been reported. The infants were doing well. This venous variant should be considered in cases of isolated coronary sinus dilatation after elimination of a left superior vena cava and a totally anomalous pulmonary vein connection.
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Affiliation(s)
- Foued Ben Brahim
- Department of Obstetrics and Gynecology, Sud Francilien Hospital, 116 rue Jean Jaures, F-91100 Corbeil-Essonnes, France.
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13
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Sanapo L, Burul G, Saccardi C, Nardelli GB, D'Antona D. Four cases of fetal intra-abdominal umbilical vein varix: a single centre's approach to management. J OBSTET GYNAECOL 2013; 33:375-7. [PMID: 23654319 DOI: 10.3109/01443615.2013.771157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Fetal intra-abdominal umbilical vein (FIUV) varix is a rare prenatal abnormality characterised by a focal intrahepatic or extrahepatic dilatation of the intra-abdominal portion of the umbilical vein. Usually, it is an isolated finding, but in some cases it can be associated to other fetal anomalies. Thrombosis is a possible complication of FIUV varix and it can lead to poor fetal or neonatal outcome. We describe four consecutive cases of FIUV varix diagnosed in our Unit and managed with low-dose aspirin (LDA) prophylaxis until the 35th week of gestation. None of the fetuses developed thrombosis of the varix and the neonatal outcomes were good in all the cases.
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Affiliation(s)
- L Sanapo
- Department of Women's and Children's Health, University of Padua, Italy
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Melcer Y, Ben-Ami I, Wiener Y, Livne A, Herman A, Maymon R. Long-term outcomes of children with umbilical vein varix diagnosed prenatally. Prenat Diagn 2013; 33:492-6. [DOI: 10.1002/pd.4098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Y. Melcer
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University; Tel-Aviv Israel
| | - I. Ben-Ami
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University; Tel-Aviv Israel
| | - Y. Wiener
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University; Tel-Aviv Israel
| | - A. Livne
- Center for Pediatric Neurology, Child Development and Pediatric Neurological Rehabilitation; Assaf Harofeh Medical Center; Zerifin Tel-Aviv Israel
| | - A. Herman
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University; Tel-Aviv Israel
| | - R. Maymon
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University; Tel-Aviv Israel
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15
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Bas-Lando M, Rabinowitz R, Samueloff A, Latinsky B, Schimmel MS, Chen O, Grisaru-Granovsky S. The prenatal diagnosis of isolated fetal varix of the intra-abdominal umbilical vein is associated with favorable neonatal outcome at term: a case series. Arch Gynecol Obstet 2013; 288:33-9. [PMID: 23389248 DOI: 10.1007/s00404-013-2743-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Varix of the fetal intra-abdominal umbilical vein (VFIUV) has been reported to be associated with an increased risk of adverse perinatal outcome and especially with intra-uterine fetal demise (IUFD). Induction of preterm birth, as early as 32-34 weeks gestation has been suggested to minimize this risk. We aimed to evaluate our center experience with the antenatal diagnosis of VFIUV and review the relevant literature. METHODS This is a retrospective case series of all cases (between 2004 and 2009) where the sonographic antenatal diagnosis of VFIUV was registered at any gestational age (GA). Ultrasound, maternal and newborn electronic medical records were used. Descriptive statistics were employed as appropriated and correlation coefficient (r) calculated. RESULTS We identified 24 women with fetuses, with isolated VFIUV (excluding one lost-to-follow-up). GA at diagnosis was 30.5 ± 4.4 weeks; 13 (56.5 %) cases were diagnosed <32 weeks. The mean VFIUV diameter was 13 ± 2.9 (range 9-20) mm and turbulent flow was reported in 7 cases (30.4 %). GA at birth was 37 ± 2.5 weeks. The small for gestational age rate was 4 % (1/23), while no case of IUFD occurred. The group induction of labor rate was 65.2 %, while 43 % (10/23) due to the diagnosis of VFIUV alone: 17 % (4/23) preterm and 26 % (6/23) at term. The cesarean rate was 17 % (4/23) and NICU admission was required for five neonates (21.7 %). The preterm induction of birth was related to a significantly increased risk for cesarean and neonatal morbidity (p = 0.015; p = 0.029, respectively). The mode of delivery was not associated with the GA at diagnosis, size/type of flow of VFIUV (r = 0.101; r = 0.727; r = 0.671, respectively) overall (r) = 0.4. All fetuses were live-born with normal follow-up at 2-60 months. CONCLUSION Isolated VFIUV has a favorable perinatal outcome at term, unrelated to the structural and flow characteristics of VFIUV. We show that follow-up for growth abnormalities with no preterm induction of birth is a safe maternal and neonatal approach.
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Affiliation(s)
- Maayan Bas-Lando
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, The Hebrew University, 12 Bezek Road, 91031 Jerusalem, Israel.
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16
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Weichert J, Hartge D, Germer U, Axt-Fliedner R, Gembruch U. Persistent right umbilical vein: a prenatal condition worth mentioning? ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:543-8. [PMID: 20922781 DOI: 10.1002/uog.7764] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2010] [Indexed: 05/09/2023]
Abstract
OBJECTIVES To investigate the incidence and clinical impact of prenatally diagnosed persistent right umbilical vein (PRUV) in a referral population and to evaluate the findings together with those from previous publications. METHODS This was a retrospective analysis of 39 cases with PRUV diagnosed in three tertiary referral centers for prenatal medicine between 1996 and 2009. Fetuses with situs inversus, situs ambiguous and heterotaxy (left and right isomerism) were excluded. During the study period 46 653 consecutive high- and low-risk pregnancies were examined. The prenatal sonograms and neonatal outcome data of affected individuals were reviewed. Our findings were analyzed together with findings retrieved from the scientific literature. RESULTS Twenty-nine fetuses had an isolated PRUV as a single anomaly, whereas 10/39 (25.6%) were found to have PRUV accompanied by additional minor and major abnormalities. These anomalies comprised mainly cardiovascular, genitourinary and gastrointestinal malformations. In common with our series, previously published cases of isolated PRUV (n = 197) displayed an uneventful course of pregnancy and a favorable postnatal outcome. Sixty-six previously reported cases of PRUV with additional anomalies were identified in the literature. Intrahepatic umbilical drainage is the most frequent type of PRUV. Including our cases, there were 16 cases (5.3%) with extrahepatic drainage of PRUV, all of which had additional anomalies. CONCLUSIONS Consistent with previous reports, in the majority of cases (74.8%) PRUV is an isolated finding. While these cases carry an excellent prognosis, PRUV can be associated with severe congenital anomalies, so this finding should prompt detailed prenatal assessment of the fetus.
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Affiliation(s)
- J Weichert
- Division of Prenatal Medicine, Department of Gynecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Luebeck, Germany.
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17
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Karatza A, Tsamandas A, Varvarigou A, Davlouros P, Pavlou V, Mantagos S. Supernumerary umbilical vein in a hydropic neonate with hypertrophic cardiomyopathy. Fetal Pediatr Pathol 2011; 30:173-6. [PMID: 21355676 DOI: 10.3109/15513815.2010.547557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The anomalies of the umbilical vessels are uncommon, with the exception of a single umbilical artery. We report a term female infant with fetal hydrops, hypertrophic cardiomyopathy, and a four-vessel umbilical cord consisting of two umbilical arteries and two umbilical veins. The presence of two veins in the umbilical cord has been attributed to persistence of both the normal left umbilical vein and the caudal part of the right umbilical vein. This fetal vascular pathology has been reported very rarely and may be associated with increased risk of congenital malformations and adverse perinatal outcome.
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Affiliation(s)
- Ageliki Karatza
- Department of Paediatrics, University of Patras Medical School, General University Hospital of Patras, Rio Patras, Greece.
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18
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Puvabanditsin S, Garrow E, Bhatt M, Kathiravan S, Gowda S, Wong R, Nagar M. Four-vessel umbilical cord associated with multiple congenital anomalies: a case report and literature review. Fetal Pediatr Pathol 2011; 30:98-105. [PMID: 21391749 DOI: 10.3109/15513815.2010.524687] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A case is described of a neonate with a four-vessel umbilical cord containing two arteries and two veins. This was due to a rare persistence of the caudal portion of the right umbilical vein. The infant had multiple congenital anomalies including a complete atrioventricular canal, an interrupted inferior vena cava, a double superior vena cava, a left ventricular hypoplasia, dextrocardia, situs ambiguous, and malrotation of the small bowel. The birth of an infant with a four-vessel cord mandates comprehensive work-up for associated anomalies. The literature is reviewed.
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Affiliation(s)
- Surasak Puvabanditsin
- Department of Pediatrics, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA.
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Vanrykel K, Bruneel E, Van Hoestenberghe MR, Buekenhout L, Gyselaers W, Theyskens C. Neonatal disseminated intravascular coagulation after thrombosis of a fetal intra-abdominal umbilical vein varix. J OBSTET GYNAECOL 2010; 30:315. [PMID: 20373943 DOI: 10.3109/01443610903531402] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- K Vanrykel
- Neonatal Intensive Care Unit, Ziekenhuis Oost Limburg Campus Sint-Jan, Schiepse Bos 6, B-3600 Genk, Belgium
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20
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Achiron R, Gindes L, Gilboa Y, Weissmann-Brenner A, Berkenstadt M. Umbilical vein anomaly in fetuses with Down syndrome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:297-301. [PMID: 20069683 DOI: 10.1002/uog.7542] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To describe the prevalence of abnormal umbilical vein (UV) anatomy in fetuses with Down syndrome. METHODS This was a retrospective survey covering a 24-month period of fetuses with a genetic diagnosis of Down syndrome following a routine early second-trimester (12-16-week) detailed fetal anomaly scan at a single academic tertiary referral center. In our unit this exam includes fetal umbilicoportal venous system evaluation. RESULTS During the study period, 37 fetuses were diagnosed with Down syndrome and had a detailed early anatomy scan. In four (11%) the detailed early anomaly scan revealed that the UV was connected to the hepatic portion of the inferior vena cava (IVC) at a position lower than its usual site. Their average gestational age at diagnosis was 13 + 6 (range, 11 + 6 to 15 + 2) weeks. Three of the four fetuses had a nuchal translucency thickness of 3-4 mm. In one fetus there was an additional finding of significant tricuspid regurgitation and the one with normal nuchal translucency thickness had an atrioventricular septal defect (atrioventricular canal) and umbilical cord hernia. During the same period three of 2500 (0.12%) fetuses with normal karyotype demonstrated similar anomalous insertion of the UV into the IVC, creating a portocaval shunt which had normal ductus venosus-like Doppler flow in all three cases. The odds ratio for abnormal umbilicoportal venous system in fetuses with Down syndrome compared with the normal population was 107.4 (95% CI, 19.2-637.1). CONCLUSIONS Fetuses with Down syndrome demonstrate an increased prevalence of abnormal connection of the UV to the IVC.
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Affiliation(s)
- R Achiron
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Kivilevitch Z, Gindes L, Deutsch H, Achiron R. In-utero evaluation of the fetal umbilical-portal venous system: two- and three-dimensional ultrasonic study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 34:634-642. [PMID: 19953568 DOI: 10.1002/uog.7459] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To describe the normal anatomy of the fetal umbilical-portal venous system (UPVS) and to assess possible anatomical variants of the main portal vein (MPV) insertion into the portal sinus (PS). METHODS This was a prospective cross-sectional study of low-risk patients between 14 and 36 weeks of gestation. Two- (2D) and three-dimensional (3D) ultrasound techniques combined with color and high-definition flow Doppler were used to evaluate the fetal UPVS. The standard transverse plane of the fetal upper abdomen, used for measuring the abdominal circumference, was taken in all cases as the point of reference. A longitudinal section was taken to identify the normal course of the umbilical vein and ductus venosus (DV). We performed offline analysis of all gray-scale and color Doppler 2D and 3D volume datasets. RESULTS Two hundred and eight fetuses were included in the study. The umbilical vein was observed to course in a cephalad direction from its entry point into the fetal abdomen, joining the L-shaped PS, a confluence of vessels that is the main segment of the left portal vein (LPV). Three branches emerge from the LPV: two to the left, the inferior and superior branches, and one to the right, the medial branch. The main LPV then courses abruptly to the right. Following the emergence of the DV, the communication of the MPV with the LPV marks the point at which the vessel becomes the right portal vein (RPV), giving rise to its anterior and posterior branches. We were able to define three main variants of connection between the MPV and the PS. In 140 (67.3%) fetuses the MPV was connected to the LPV in an end-to-side T-shaped anastomosis, in 26 (12.5%) fetuses the MPV connected with a side-to-side X-shaped anastomosis and in 30 (14.4%) fetuses the two vessels ran in parallel with a short communicating segment, in an H-shaped anastomosis. In the remaining 12 (5.7%) cases classification into one of these three groups was not possible due to intermediate morphology. CONCLUSIONS Knowing the normal anatomy of the UPVS and being aware of the possible variants of the connection between the MPV and the PS is a fundamental requirement for accurate prenatal diagnosis of the anomalies of the fetal UPVS.
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Affiliation(s)
- Z Kivilevitch
- Maccabi Health Services, Ultrasound Unit, The Negev Medical Center, Beer Sheba, Israel
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Weissmann-Brenner A, Simchen MJ, Moran O, Kassif E, Achiron R, Zalel Y. Isolated fetal umbilical vein varix-prenatal sonographic diagnosis and suggested management. Prenat Diagn 2009; 29:229-33. [DOI: 10.1002/pd.2219] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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23
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Ipek A, Kurt A, Tosun O, Gümüş M, Yazicioğlu KR, Aşik E, Taş I. Prenatal diagnosis of fetal intra-abdominal umbilical vein varix: report of 2 cases. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:48-50. [PMID: 17436317 DOI: 10.1002/jcu.20334] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Fetal intra-abdominal umbilical vein varix (FIUVV) is a focal aneurysmal dilatation of the umbilical vein. Its clinical importance has not yet been clearly established, but it has been reported to be associated with increased fetal death rate (in nearly 44% of cases) and chromosomal abnormalities (in 12% of cases). We report 2 cases of FIUVV diagnosed via sonography in the third trimester.
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Affiliation(s)
- Ali Ipek
- Department of Radiology, Ankara Atatürk Education and Research Hospital, 06800 Eskişehir Yolu 8.km No. 3, Bilkent, Ankara, Turkey
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Adkins EA, Ward DA, Daniel GB, Wooten PT. Coil embolization of a congenital orbital varix in a dog. J Am Vet Med Assoc 2005; 227:1952-4, 1928-9. [PMID: 16379632 DOI: 10.2460/javma.2005.227.1952] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 10-week-old Labrador Retriever was examined because of a swelling above the left eye. Ophthalmic examination revealed a tubular, light-pink, slightly raised lesion of the left conjunctiva that extended from the limbus to the fornix and into the dorsal eyelid. The lesion affected the entire margin of the dorsal eyelid and extended 2 cm dorsal to the eyelid margin. With compression of the left jugular vein, the exophthalmos worsened immediately and the subconjunctival and eyelid lesion enlarged. Results of ultrasonography, computed tomography, and contrast venography were consistent with a diagnosis of an orbital varix. Coil embolization was elected for treatment of the varix to prevent the pain and morbidity associated with an orbitotomy. Coils were introduced through a 22-gauge IV catheter inserted through the upper eyelid into the varix. The only complication was moderately severe orbital swelling. The owners reported that the lesion had resolved by 2 weeks after coil embolization.
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Affiliation(s)
- Elizabeth A Adkins
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee 37996-4544, USA
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Current awareness in prenatal diagnosis. Prenat Diagn 2005. [DOI: 10.1002/pd.1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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