Is umbilical vein varix associated with changes in cerebroplacental ratio?

J Matern Fetal Neonatal Med. 2020 Jan;33(1):162-166. doi: 10.1080/14767058.2018.1487943. Epub 2018 Jul 18.

Abstract

Objective: We aimed to review a single-center experience in follow-up and management of fetuses with umbilical vein varix (UVV) and to assess the effect of UVV on fetal Doppler parameters.Methods: We reviewed retrospectively maternal antenatal records, delivery records, and newborn records to identify cases of UVV. Further, we retrospectively compared 25 fetuses with isolated UVV and available cerebroplacental ratio (CPR) analysis with 75 matched controls.Results: We identified 67 cases of UVV. The median gestational age (GA) at diagnosis was 34 weeks (range: 26-41 weeks). The average diameter of UVV at diagnosis was 10.1 mm (range: 9-14 mm). The median GA at delivery was 36 + 6 (range: 33-41 weeks), with an average birth weight of 2918 g (range: 1278-4140 g). There was a single case of intrauterine death at 35 weeks. CPR was 2.13 ± 0.62 in isolated UVV group compared with 1.84 ± 0.61 in the control group (p < .05). Other Doppler parameters did not differ between fetuses with UVV compared with controls.Conclusions: CPR was significantly increased in the UVV group compared with control fetuses. This finding suggests that UVV is not associated with chronic fetal oxygen deprivation; it, therefore, may contribute to our understanding of the pathophysiology explaining abnormal pregnancy outcome in cases with UVV.

Keywords: Cerebroplacental ratio; fetal Doppler; middle cerebral artery; umbilical artery; varix.

MeSH terms

  • Adult
  • Case-Control Studies
  • Cephalometry*
  • Female
  • Fetal Growth Retardation / diagnosis
  • Fetal Growth Retardation / epidemiology
  • Fetal Growth Retardation / etiology*
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Male
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / physiology
  • Placenta / anatomy & histology
  • Placenta / blood supply
  • Placenta / diagnostic imaging*
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / epidemiology
  • Pulsatile Flow
  • Retrospective Studies
  • Risk Factors
  • Ultrasonography, Prenatal
  • Umbilical Arteries / blood supply*
  • Umbilical Arteries / diagnostic imaging
  • Umbilical Arteries / pathology
  • Umbilical Veins / blood supply
  • Umbilical Veins / diagnostic imaging
  • Umbilical Veins / pathology
  • Varicose Veins / complications
  • Varicose Veins / diagnosis*
  • Varicose Veins / epidemiology