5 years ago

Fetal intra-abdominal umbilical vein varix: a retrospective cohort study, systematic review of the literature and meta-analysis

M. Kuleva, N. O'Gorman, E. di Pasquo, Y. Ville, L. J. Salomon
Objectives To investigate the outcome of fetuses with intra-abdominal umbilical vein varix (FIUVV) Methods A retrospective cohort study of cases of FIUVV was carried out. Information retrieved included gestational age and diameter of the umbilical varix at diagnosis, increasing in varix diameter, associated ultrasound and chromosomal anomalies and pregnancy outcome. A systematic review and a meta-analysis of the existing literature were performed to assess the incidence of chromosomal anomalies, Small for Gestational Age (SGA) infants and Intra-Uterine Fetal Demise (IUFD) and to pool relative risk (OR) estimates on the relationship between the presence of associated additional ultrasound anomalies and the occurrence of these outcomes. Results Thirteen cases of FIUVV were included in the cohort. Additional US anomalies were found in 2/13 cases (15.4%). One case of IUFD was observed. There were no cases of chromosomal anomalies or thrombosis of varix recorded. A total of 5 studies with 254 cases met inclusion criteria for the systematic review. FIUVV was associated with additional US anomalies in 19% (95% CI 10.9-29.1) of cases (non isolated-FIUVV). No case of chromosomal abnormality or IUFD was found in foetuses with isolated FIUVV. Contrarily in the group of non isolated-FIUVV the incidence of chromosomal anomalies was 19.6% (95% CI 5.1-40.4) and 5.3% of IUFD, OR of 14.8 (95% CI 2.9-73.0) and 8.2 (95% CI 1.05-63.1) respectively, when compared with the group of isolated FIUVV. Conclusions Association with additional ultrasound anomalies is an important prognostic factor for chromosomal anomalies and IUFD in fetuses with FIUVV.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.18895

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