Adiego-Calvo Ignacio, Saviron-Cornudella Ricardo, Martinez-Payo Cristina, Rubio-Aranda Encarna, Sancho-Sauco Javier, Cisneros-Gimeno Ana Isabel, Perez-Perez Pilar, Lerma-Puertas Diego, Whyte-Orozco Jaime
Department of Obstetrics and Gynecology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Department of Obstetrics and Gynecology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Taiwan J Obstet Gynecol. 2016 Dec;55(6):782-785. doi: 10.1016/j.tjog.2015.12.022.
Persistent right umbilical vein (PRUV) is a vascular anomaly where the right umbilical vein remains as the only conduit that returns oxygenated blood to the fetus. It has classically been described as associated with numerous defects. We distinguish the intrahepatic variant (better prognosis) and the extrahepatic variant (associated with worse prognosis). The objective of this study was to compare rates of congenital malformations in fetuses with intrahepatic PRUV (I-PRUV) versus singleton pregnancies without risk factors.
A multicenter, crossover design, comparative study was performed between 2003 and 2013 on fetuses diagnosed with I-PRUV (n=56), and singleton pregnancies without congenital malformation risk factors (n=4050).
Fifty-six cases of I-PRUV were diagnosed (incidence 1:770). A statistically significant association between I-PRUV and the presence of congenital malformations (odds ratio 4.321; 95% confidence interval 2.15-8.69) was found. This positive association was only observed with genitourinary malformations (odds ratio 3.038; 95% confidence interval 1.08-8.56).
Our rate of malformations associated with I-PRUV (17.9%) is similar to previously published rates. I-PRUV has shown a significant increase in the rate of associated malformations, although this association has only been found to be statistically significant in the genitourinary system. Noteworthy is the fact that this comparative study has not pointed to a significant increase in the congenital heart malformation rate. Diagnosis of isolated I-PRUV does not carry a worse prognosis.
持续性右脐静脉（PRUV）是一种血管异常，即右脐静脉作为唯一将含氧血液回流至胎儿的管道而持续存在。传统上认为它与众多缺陷相关。我们区分肝内型（预后较好）和肝外型（预后较差）。本研究的目的是比较肝内型PRUV（I-PRUV）胎儿与无危险因素的单胎妊娠胎儿的先天性畸形发生率。
2003年至2013年对诊断为I-PRUV的胎儿（n = 56）和无先天性畸形危险因素的单胎妊娠（n = 4050）进行了一项多中心、交叉设计的比较研究。
诊断出56例I-PRUV（发生率1:770）。发现I-PRUV与先天性畸形的存在之间存在统计学显著关联（优势比4.321；95%置信区间2.15 - 8.69）。这种正相关仅在泌尿生殖系统畸形中观察到（优势比3.038；95%置信区间1.08 - 8.56）。
我们的I-PRUV相关畸形发生率（17.9%）与先前发表的发生率相似。I-PRUV显示相关畸形发生率显著增加，尽管这种关联仅在泌尿生殖系统中具有统计学显著性。值得注意的是，这项比较研究并未指出先天性心脏畸形率有显著增加。孤立性I-PRUV的诊断并不意味着预后更差。
