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Lee, Cho, Kwon, Park, and Kim: A Huge Umbilical Vein Aneurysm: Case Report and a Brief Review of Literatures Describing Umbilical Vessel Aneurysm
Original Article

Korean J Perinatol 2014;25(3):178-183.

Published online: 21 September 2014

DOI: https://doi.org/10.14734/kjp.2014.25.3.178

A Huge Umbilical Vein Aneurysm: Case Report and a Brief Review of Literatures Describing Umbilical Vessel Aneurysm

Jae Hoon Lee, M.D., Ju Hyun Cho, M.D., Ha Yan Kwon, M.D., Yong Won Park, M.D., Young Han Kim, M.D.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, Seoul, Korea

Correspondence: Young Han Kim, M.D. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea Tel : +82-2-2228-2243, Fax : +82-2-313-8357 E-mail : YHKIM522@yuhs.ac

Received 11 July 201430 August 2014       Accepted 26 September 2014

Copyright © 2014 Korean Society of Perinatology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

An umbilical vein aneurysm is rare, but appears to be associated with fetal morbidity and mortality. There are no specific guidelines for pregnancy with umbilical vein aneurysm and the management is substantially up to the clinician. We report a case of intra-amniotic umbilical vein aneurysm diagnosed at 35 gestational weeks by ultrasound. Because the aneurysm was growing rapidly, prompt cesarean delivery was conducted. After delivery, a huge fusiform umbilical cord was noted, which was confirmed to be umbilical vein aneurysm by pathological examination. We also reviewed previous reported cases and summarized the management strategies of prenatally detected umbilical vein aneurysms. In addition, the umbilical vein in this case report had the largest size ever reported.

Keywords: Umbilical vein, Aneurysm, Varix, Karyotyping

REFERENCES

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Fig. 1.
The 2D and 3D sonographic findings of umbilical cord was as the following. (A) Color doppler imaging showed turbulent blood flow within the aneurism. (B) Doppler waveforms demonstrates non-pulsatile, low-velocity flow and streaming within the aneurysm. (C) 3D image of the aneurysm.
kjp-25-178-f1.tif
Fig. 2.
Gross findings of the umbilical cord was as the following. (A) The baby was born with hemorrhagic fluid filled umbilical cord dilated to 80 mm in diameter. (B) The umbilical cord was 35 cm in length, 60 mm in width with hemorrhagic fluid filled appearance. (C) Serial cut section of umbilical cord shows no vessel wall defect.
kjp-25-178-f2.tif
Table 1.
Comparisons of intra-amniotic umbilical vein aneurysm
Author GW at diagnosis GW at delivery Size of the aneurysm at delivery (Dc=diameter of the umbilical cord, Dv= diameter of the umbilical vein, L=length of the lesion) Delivery mode Fetal outcomes, accompanied fetal anomalies, complications Aneuploidy
Schröcksnadel et al. (1991)10 After delivery Full term Dv=30 mm/ Dc=40 mm L=10 cm VD IUFD, Thrombosis SUA Unknown
White et al. (1994)11 32 35 D=27 mm C/sec IUGR, Thrombosis Compression of varix Healthy (unknown)
Shipp et al. (1995)12 24.5 34 Dv=45 mm Dc=80 mm C/sec Thrombosis VSD, dilated SVC Unknown
Babay et al. (1996)13 30 39 D=20 mm L=15 cm VD n-c Healthy (unknown)
Vandevijet al. (2000)14 After delivery 41 D=40 mm VD IUFD Thrombosis Unknown
Berg et al (2001)4 34 34 Dv=19 mm L=1.8 cm Termination IUFD, IUGR, AV fistula multiple anomaly Trisomy 18
Kristie, Cruise et al. (2002)15 24 32 D=50 mm L=11 cm VD IUFD, Thrombosis Klippel-Trenaunay-Weber Syndrome Unknown
Zachariah et al. (2004)15 After delivery 41 D=60 mm L=80 mm VD Thrombosis Healthy (unknown)
Panda et al. (2009)17 34 36 Dv=32 mm/ Dc=50 mm L=5 cm C/sec n-c Healthy (unknown)
Akar et al. (2012)18 31 37 D=30 mm L=3 cm C/sec Demised at 2month after birth Thrombosis Imperforate anus, Atresia vulvae Unknown
Deront-Bourdin et al. (2014)19 31 34 D=70 mm/ L=20 cm C/sec n-c Healthy (unknown)
This case 34 35 Dv=39 mm/ Dc=60 mm L=35 cm C/sec n-c Healthy (unknown)

Abbreviations: GW, gestational week; VD, vaginal delivery; IUFD, Intrauterine Fetal Death; SUA, Single umbilical Artery; C/ sec, Cesarean-section; IUGR, Intrauterine Growth Restriction; VSD, Ventricular Septal Defect; SVC, superior vena cava

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