Severe fetal anemia as a consequence of extra-abdominal umbilical vein varix: A case report and review of the literature.
fetal anemia
fetal transfusion
umbilical cord
umbilical vein varix
varicose vein
Journal
Congenital anomalies
ISSN: 1741-4520
Titre abrégé: Congenit Anom (Kyoto)
Pays: Australia
ID NLM: 9306292
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
29
05
2020
revised:
12
10
2020
accepted:
16
10
2020
pubmed:
26
10
2020
medline:
13
10
2021
entrez:
25
10
2020
Statut:
ppublish
Résumé
Umbilical vein varix is associated with a high incidence of fetal anomalies and perinatal complications. There are two types of umbilical vein varix: fetal intra-abdominal and extra-abdominal. Herein, a case is reported of severe fetal anemia with extra-abdominal umbilical vein varix. A 33-year-old primigravida was referred to our hospital for fetal growth restriction, fetal cardiomegaly, and decreased fetal movements at 26 weeks' gestation. A Doppler assessment showed an elevated middle cerebral artery peak systolic velocity at 2.2 MoM, suggesting fetal anemia. Umbilical vein varix had caused intermittent turbulent flow, provoking hemolytic anemia. Intrauterine transfusion improved fetal circulatory failure and anemia and prolonged gestational period. At 33 weeks' gestation, the patient underwent cesarean delivery due to nonreassuring fetal status. Pathological analysis revealed focal loss of vascular smooth muscle of the umbilical vein. Extra-abdominal umbilical vein varix has been reported in 14 cases including this case. The antenatal diagnosis rate is reported to be 79%; fetal heartbeat abnormalities and fetal deaths were reported as 50% and 14%, respectively. Eighty-six percent of patients had intra-umbilical cord thrombosis, but currently this is the only case of hemolytic anemia. Furthermore, extra-abdominal umbilical vein varix may present as fetal hydrops with anemia. During ultrasound examination of fetal anemia, umbilical cord screening should be performed with caution.
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4-8Informations de copyright
© 2020 Japanese Teratology Society.
Références
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