VP20.06: Fetal intra‐abdominal umbilical vein varix: retrospective study and review of literature

Abstract

To investigate the ultrasound characteristics, associations and obstetric outcome in pregnancies with intra-abdominal umbilical vein varix of the fetus. It was a retrospective cohort study conducted over two years i.e., from March 2019- February 2021. Data was collected from ultrasound records, antenatal and intra- partum records. For the neonatal outcome patients and respective consultants were followed up by telephonic calls. The data collected was demographic characteristics, varix characteristics (gestational age at diagnosis, size, progression, turbulence, thrombus formation, associated malformations and genetic), obstetric complications (fetal growth restriction/ IUFD) and neonatal outcome. Descriptive statistics (means, standard deviations, and percentages [%]) were calculated using SPSS, version 21.0 (SPSS Inc, Chicago, USA). Over the period of 2 years six cases of FIUVV were diagnosed making the incidence of FIUVV of 5/10000 pregnancies. Incidence of isolated FIUVV was 4.4/10000 cases. The mean gestational age at diagnosis was 25 weeks 3days with earliest diagnosis at 19w1d. Aneuploidy screening was done in five of cases with low risk for trisomy 21, 18 & 13 as outcome. The mean varix size was 11.85mm±2.28 mm (range 8.9mm-14.8 mm). No incidence of turbulence or thrombus formation within the varix was seen in the current study. One case had absent DV with anomalous connection of umbilical vein with IVC. One Perinatal death after planned LSCS at term & sudden IUFD at 33 weeks were noted in this study. Detailed anatomical scan and counselling should be done after FIUVV diagnosis. The fetal surveillance should be increased to look for major dilatation thombus or FGR. Longer analysis on the large population is needed to study the association of controls with the outcome. Also, long term studies are needed to for any delayed consequences affecting the adult life of these fetuses.