Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Campos A, Elfeky M, et al. Umbilical vein varix. Reference article, Radiopaedia.org (Accessed on 02 Dec 2024) https://doi.org/10.53347/rID-13567
Umbilical vein varix (UVV) refers to a focal dilatation of the umbilical vein.
Associations
UVVs were initially thought to have a high association with other anomalies which include:
Literature points to more favorable outcomes when FIUVV is an isolated finding, with significantly lower associations with aneuploidy and mortality than initially reported 14,15.
Location
It tends to favor the intra-abdominal portion of the cord (typically between the abdominal wall and the liver) which is then termed a fetal intra-abdominal umbilical vein varix (FIUVV) or the intra-amniotic portion of the umbilical vein.
Ultrasound
Using antenatal ultrasound, an intra-abdominal UVV may be seen as a cyst-like structure in the fetal upper abdomen with venous flow within on color Doppler interrogation. The term umbilical varix is defined when the caliber is greater than 9 mm or with a ratio of more than 50% between the dilated and a more distal normal intra-abdominal portion of the vein.
Treatment and prognosis
The overall clinical course is variable and unpredictable ranging from favorable in some to unfavorable in others 6. Most cases with an isolated varix have a very good prognosis; most neonates will have a normal outcome.
Complications
Due to its association with other fetal anomalies and relatively high mortality rates (when not an isolated finding), a careful fetal search for other abnormalities as well as close monitoring is recommended if detected prenatally. Follow-up is warranted when an umbilical vein varix is diagnosed (growth and well being), more so if other abnormalities are identified 1,7.
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2. Ipek A, Kurt A, Tosun O et-al. Prenatal diagnosis of fetal intra-abdominal umbilical vein varix: report of 2 cases. J Clin Ultrasound. 2008;36 (1): 48-50. doi:10.1002/jcu.20334 - Pubmed citation
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3. Sepulveda W, Mackenna A, Sanchez J et-al. Fetal prognosis in varix of the intrafetal umbilical vein. J Ultrasound Med. 1998;17 (3): 171-5. J Ultrasound Med (abstract) - Pubmed citation
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4. Fung T, Leung T, Leung T, Lau T. Fetal Intra-Abdominal Umbilical Vein Varix: What is the Clinical Significance? Ultrasound Obstet Gynecol. 2005;25(2):149-54. doi:10.1002/uog.1815 - Pubmed
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5. Byers BD, Goharkhay N, Mateus J et-al. Pregnancy outcome after ultrasound diagnosis of fetal intra-abdominal umbilical vein varix. Ultrasound Obstet Gynecol. 2009;33 (3): 282-6. doi:10.1002/uog.6233 - Pubmed citation
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6. Valsky D, Rosenak D, Hochner-Celnikier D, Porat S, Yagel S. Adverse Outcome of Isolated Fetal Intra-Abdominal Umbilical Vein Varix Despite Close Monitoring. Prenat Diagn. 2004;24(6):451-4. doi:10.1002/pd.897 - Pubmed
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7. Zalel Y, Lehavi O, Heifetz S et-al. Varix of the fetal intra-abdominal umbilical vein: prenatal sonographic diagnosis and suggested in utero management. Ultrasound Obstet Gynecol. 2000;16 (5): 476-8. doi:10.1046/j.1469-0705.2000.00283.x - Pubmed citation
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8. Mahony B, McGahan J, Nyberg D, Reisner D. Varix of the Fetal Intra-Abdominal Umbilical Vein: Comparison with Normal. J Ultrasound Med. 1992;11(2):73-6. doi:10.7863/jum.1992.11.2.73 - Pubmed
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9. White SP, Kofinas A. Prenatal diagnosis and management of umbilical vein varix of the intra-amniotic portion of the umbilical vein. J Ultrasound Med. 1994;13 (12): 992-4. J Ultrasound Med (citation) - Pubmed citation
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10. Jeanty P. Fetal and Funicular Vascular Anomalies: Identification with Prenatal US. Radiology. 1989;173(2):367-70. doi:10.1148/radiology.173.2.2678250 - Pubmed
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11. Panda B, Stiller R, Iruretagoyena I et-al. Prenatal diagnosis of an umbilical vein aneurysm: a case report. Conn Med. 2009;73 (8): 465-7. - Pubmed citation
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12. David A. Nyberg. Diagnostic Imaging of Fetal Anomalies. (2003) ISBN: 9780781732116 - Google Books
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13. Mankuta D, Nadjari M, Pomp G. Isolated Fetal Intra-Abdominal Umbilical Vein Varix: Clinical Importance and Recommendations. J Ultrasound Med. 2011;30(2):273-6. doi:10.7863/jum.2011.30.2.273 - Pubmed
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14. Lee S, Kim M, Kim J, Chung J, Lee H, Yoon J. Clinical Characteristics and Outcomes of Antenatal Fetal Intra-Abdominal Umbilical Vein Varix Detection. Obstet Gynecol Sci. 2014;57(3):181-6. doi:10.5468/ogs.2014.57.3.181 - Pubmed
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15. Byers B, Goharkhay N, Mateus J, Ward K, Munn M, Wen T. Pregnancy Outcome After Ultrasound Diagnosis of Fetal Intra-Abdominal Umbilical Vein Varix. Ultrasound Obstet Gynecol. 2009;33(3):282-6. doi:10.1002/uog.6233 - Pubmed
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