Fetal Intra-abdominal Umbilical Vein Aneurysm

    loading  Checking for direct PDF access through Ovid

Abstract

Importance

Fetal umbilical vein aneurysm is an uncommon anomaly that accounts for approximately 4% of umbilical cord abnormalities. The rate of intrauterine fetal death is reported to be approximately 4% to 5%, higher than the background rate of 0.7% that is generally reported during pregnancy.

Objective

The aim of this study was to review the pathophysiology, diagnosis, and clinical management of fetal umbilical vein aneurysm.

Evidence Acquisition

Advances in high-resolution ultrasound combined with color Doppler and 3-dimensional rendering have contributed to an increased understanding of the fetal venous circulation in recent years.

Results

When the diagnosis of umbilical vein aneurysm is made, the patient should undergo a detailed ultrasound evaluation of the fetal anatomy, including fetal echocardiography, to exclude associated anomalies. Amniocentesis should be offered when other anomalies are found. Patients should be informed about the potential for an unfavorable outcome of pregnancy and should undergo close ultrasound surveillance to assess the size of the aneurysm, as well as any evidence of thrombosis or signs of hydrops.

Conclusions

The main prognostic feature associated with a poor outcome of umbilical vein aneurysm seems to be the presence of other anomalies. Early diagnosis is associated with a somewhat worse prognosis, and most fetal deaths have been observed between 27 and 30 weeks of gestation. In the third trimester, it is reasonable to perform serial ultrasound examinations to assess fetal growth, the size of the aneurysm, and the blood flow pattern within the aneurysm.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this activity, the learner should be better able to describe the overall pathophysiology of fetal umbilical vein aneurysm, recall the diagnosis and classification of fetal umbilical aneurysm, identify the ultrasound markers in a prognostic view, and explain the obstetrics management of fetuses with umbilical vein aneurysm.

Related Topics

    loading  Loading Related Articles