Fetal Umbilical Vein Varix

This was a 27 year old lady , Gravida 2, Para 1 , Live 1 , Miscarriage 0.

The scan was done around the 35 weeks.The following images were seen .

The lower intra abdominal vein is unusually dilated

spectral doppler shows venous flow

glass body view – 3d reconstruction of umbilical vessels

glass body view of umbilical vein varix, heart, aortic arch and aorta

colour doppler 3 d reconstruction

apart from this the placenta showed a few lakes and a localised mass , probably chorio angioma

placenta showing a mass lesion

3 D reconstruction of placental mass lesion

placental lake

No other fetal anomaly was made out

the important views of the heart are shown below

4 chamber view

3 vessel view

LVOT view

Mild polyhydramnios was seen

mild polyhydramnios

fetal face

The differential diagnosis : urachal or  ovarian cyst  ;  easily differentiated  with the Doppler examination.

An umbilical varix is a developmental rather an embryologic abnormality and most cases have a normal ultrasound at 16 to 19 weeks gestation.

Unlike persistent right umbilical vein, umbilical vein varices have not been associated with other congenital malformations.

The significance of an antenatally detected umbilical varix remains controversial.

This finding has been associated with an unexplained high mortality rate in utero: thrombosis of the dilation leading to fetal death and other complications including hydrops fetalis. It had also been linked with chromosomal abnormalities. 

  Karyotyping is not warranted if not any associated malformation is detected.

When a fetal intra-abdominal umbilical vein varix is isolated, a good fetal outcome is expected.

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