103 - Cord Varix

Abstract

Umbilical vein varix (UVV) is a rare, idiopathic, focal dilatation of the umbilical vein, either within the intraamniotic portion of the umbilical cord or within the fetal abdomen. On ultrasound (US), UVV appears as a round or fusiform anechoic structure that is located either within the umbilical cord or within the fetal abdomen, inferior to the fetal liver and close to the anterior abdominal wall. Color flow, power Doppler, and pulsed wave Doppler US are useful to confirm the vascular nature of this lesion by showing venous flow in its lumen. Although the precise etiology of UVV is unknown, it has been speculated that any condition that increases venous pressure could potentially lead to dilatation of the extrahepatic portion of the umbilical vein because this anatomic region is the weakest area of umbilical circulation. Another suggested mechanism is an intrinsic weakness of the umbilical vein wall that subsequently leads to venous dilatation and the development of the varix. UVV is associated with a high rate of fetal anomalies and a potentially increased risk of fetal demise. The finding of a UVV should prompt a thorough search for other structural malformations and potentially aneuploidy testing. Serial growth measurements and antenatal surveillance are also recommended. There are currently no prenatal or postnatal treatment options for fetuses with UVV; however, due to the association with intrauterine fetal demise, early term delivery should be considered.