J Obstet Gynaecol Can. 2025 Oct 27:103165. doi: 10.1016/j.jogc.2025.103165. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess obstetrical and neonatal outcomes associated with isolated fetal intra-abdominal umbilical vein varix and review relevant literature.
METHODS: A retrospective population-based review of singleton pregnancies with isolated fetal intra-abdominal vein varix between 2004 and 2020 at three tertiary centres was conducted. Outcomes included intrauterine fetal demise, varix ultrasound characteristics, obstetrical and neonatal outcomes. Descriptive statistics were used for analysis.
RESULTS: Among 85 cases of isolated umbilical vein varix, no fetal demise was observed. Median gestational age at diagnosis of varix was 323 weeks (IQR 201-340). Median varix diameter at diagnosis was 11 mm (IQR 10-13), and maximum diameter was 12 mm (IQR 11-14). Nine cases (10.59%) had an abdominal circumference <10th percentile. Induction of labour was initiated in 54 (63.5%) cases, with varix as primary indication in 35 (64.81%). Median age at delivery was 374 weeks (IQR 370-381), with 11 (12.64%) cases of preterm birth <37 weeks (none due to abnormal fetal monitoring). Median neonatal birthweight was 2975 grams (IQR 2674-3378), and nine (11.11%) newborns underwent NICU admission, none related to umbilical vein varix.
CONCLUSIONS: Our findings are consistent with recent studies demonstrating a favourable prognosis for isolated fetal intra-abdominal umbilical vein varix. In our literature review, of 511 cases of isolated umbilical vein varix, there were 11 cases of fetal demise (2.15%). In our study population, we did not observe any demise. As the largest Canadian cohort, these findings are extremely valuable in counselling patients with this rare diagnosis and support current recommendations for work-up and surveillance.
PMID:41161477 | DOI:10.1016/j.jogc.2025.103165
