Maternité Hôpital Necker-Enfants Malades, Assistance Publique, Hôpitaux de Paris, Université Paris Descartes, Paris, France.
Société Française pour l'Amélioration des Pratiques Echographiques, Paris, France.
Ultrasound Obstet Gynecol. 2018 May;51(5):580-585. doi: 10.1002/uog.18895.
To investigate the ultrasound characteristics and outcome of pregnancies with fetal intra-abdominal umbilical vein varix (FIUVV).
Cases of FIUVV managed at our tertiary university hospital over an 8-year period were reviewed. Information retrieved included gestational age and diameter of the umbilical varix at diagnosis, increase in varix diameter, associated ultrasound or chromosomal anomalies and pregnancy outcome. Furthermore, a systematic review and meta-analysis of series of FIUVV in the literature was performed to assess the incidence of chromosomal anomalies, small-for-gestational age infants and intrauterine fetal demise (IUFD), and to pool odds ratio (OR) estimates on the relationship between the incidence of these outcomes and the presence of additional associated ultrasound anomalies.
Thirteen cases of FIUVV were included in the cohort study. Additional ultrasound anomalies were found in two (15.4%) of 13 cases. One case of IUFD was observed and no case of chromosomal anomaly or thrombosis of varix was recorded. A total of five studies comprising 254 cases met the inclusion criteria of the systematic review. FIUVV was associated with additional ultrasound anomalies (non-isolated FIUVV) in 19% (95% CI, 10.9-29.1%) of cases. No case of chromosomal abnormality or IUFD was reported in fetuses with isolated FIUVV. In contrast, in the group of non-isolated FIUVV, the incidence of chromosomal anomalies was 19.6% and that of IUFD was 7.3%, with ORs of 14.8 (95% CI, 2.9-73.0) and 8.2 (95% CI, 1.05-63.1), respectively, when compared with the group of isolated FIUVV.
When isolated, the outcome of cases affected by FIUVV is usually favorable. In about 20% of cases, additional ultrasound anomalies are found, which are associated with an increased risk for chromosomal abnormalities and IUFD. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
探讨胎儿腹腔内脐静脉静脉瘤（FIUVV）的超声特征及妊娠结局。
回顾性分析了我院 8 年来收治的 FIUVV 患者。检索的信息包括诊断时的胎龄和脐静脉瘤直径、静脉瘤直径的增加、相关的超声或染色体异常以及妊娠结局。此外，对 FIUVV 文献中的系列进行了系统回顾和荟萃分析，以评估染色体异常、小于胎龄儿和宫内胎儿死亡（IUFD）的发生率，并对这些结局发生率与其他相关超声异常之间的关系进行汇总优势比（OR）估计。
本队列研究纳入了 13 例 FIUVV 患者。在 13 例中，有 2 例（15.4%）发现了其他超声异常。观察到 1 例 IUFD，无染色体异常或静脉瘤血栓形成病例记录。共有 5 项研究共纳入 254 例符合系统综述纳入标准的患者。FIUVV 与 19%（95%CI，10.9-29.1%）的病例中其他超声异常（非孤立性 FIUVV）相关。孤立性 FIUVV 胎儿中无染色体异常或 IUFD 病例报告。相比之下，在非孤立性 FIUVV 组中，染色体异常的发生率为 19.6%，IUFD 的发生率为 7.3%，OR 分别为 14.8（95%CI，2.9-73.0）和 8.2（95%CI，1.05-63.1），与孤立性 FIUVV 组相比。
孤立性 FIUVV 病例的结局通常较好。约 20%的病例存在其他超声异常，这与染色体异常和 IUFD 的风险增加有关。版权所有©2017ISUOG。由 John Wiley & Sons Ltd 出版。
