Campbell Meredith S, Craig Amanda M, Reese Jeff, Crum Alicia K, Patel Soha S
Division of Neonatology, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
Case Rep Obstet Gynecol. 2021 Nov 16;2021:2433252. doi: 10.1155/2021/2433252. eCollection 2021.
Fetal umbilical vein aneurysm is an uncommon anomaly without clear guidelines regarding the management of these pregnancies. . We describe an ultrasound diagnosis of this condition involving a 38-year-old multigravid woman who presented at 30 weeks and 3 days gestation with severe fetal growth restriction, reverse end-diastolic flow on umbilical artery dopplers, elevated ductus venosus doppler, and an umbilical vein aneurysm. Due to nonreassuring fetal assessment in the setting of an umbilical vein aneurysm, she underwent a cesarean delivery with a favorable neonatal outcome.
There are currently no guidelines for the management of an umbilical vein aneurysm. This case demonstrates a successful multidisciplinary approach for creating a plan of care focused on achieving a favorable outcome for a fetus with a large umbilical vein aneurysm. The approach took into account timing of delivery given the potential for fetal morbidity and mortality, while factoring in the risk of prematurity.
胎儿脐静脉瘤是一种罕见的异常情况,对于这类妊娠的管理尚无明确指南。我们描述了一例通过超声诊断出该病症的病例,患者为一名38岁的经产妇,妊娠30周零3天时就诊,伴有严重胎儿生长受限、脐动脉多普勒舒张末期血流逆转、静脉导管多普勒升高以及脐静脉瘤。由于在脐静脉瘤情况下胎儿评估结果不乐观,她接受了剖宫产,新生儿结局良好。
目前尚无脐静脉瘤管理的指南。本病例展示了一种成功的多学科方法,用于制定以实现患有大脐静脉瘤胎儿的良好结局为重点的护理计划。该方法考虑了鉴于胎儿发病和死亡可能性的分娩时机,同时兼顾了早产风险。