Significantly enlarged varix in the free-loop of the umbilical cord during the second trimester
-
Akiko Kurasaki
,
Natsumi Furuya
,
Chika Homma
Abstract
Objectives
Umbilical cord varix is an abnormal dilatation of the umbilical vein. There are two types of umbilical venous varix, of which the free-loop type is extremely rare, and the prognosis and etiology are unclear. In this report, we present a case of a significantly enlarged varix in the free loop of the umbilical cord found in the second trimester.
Case presentation
Cesarean section was performed at 28 weeks’ gestation due to enlargement of the varix and rapidly increased umbilical venous velocity at the outlet of the varix. Neonatal blood tests revealed anemia and high concentrations of D-dimer, and they were considered to be due to clot formation inside the umbilical cord venous varix. The neonate received blood transfusion but other neonatal course was generally favorable. Thrombus formation in the enlarged varix was due to the constriction of the umbilical cord.
Conclusions
This case showed that the assessment of umbilical venous flow velocity can be used for estimating the constriction of the umbilical vein and for determining the timing of delivery.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: All of the procedures performed in the present study were carried out in accordance with the ethical standards of the responsible committees on human experimentation (institutional and national) and the Helsinki Declaration of 1975, as revised in 2008 (5).
References
1. Fung, TY, Leung, TN, Leung, TY, Lau, TK. Fetal intra-abdominal umbilical vein varix: what is the clinical significance? Ultrasound Obstet Gynecol 2005;25:149–54. https://doi.org/10.1002/uog.1815.Search in Google Scholar PubMed
2. Beraud, E, Rozel, C, Milon, J, Darnault, P. Umbilical vein varix: importance of ante- and post-natal monitoring by ultrasound. Diagn Interv Imaging 2015;96:21–6. https://doi.org/10.1016/j.diii.2014.01.009.Search in Google Scholar PubMed
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/crpm-2019-0006).
© 2020 Walter de Gruyter GmbH, Berlin/Boston
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