PDF herunterladen
CC BY-NC-ND 4.0 · AJP Rep 2021; 11(02): e76-e79
DOI: 10.1055/s-0041-1727288
Case Report

Severe Consumptive Coagulopathy in an Extremely-Low-Birth-Weight Infant with Intra-Abdominal Umbilical Vein Varix: A Case Report

Mitsuhiro Haga 
1   Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
,
Kanako Itoh
1   Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
,
Tsuguhiro Horikoshi
2   Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
,
Fumihiko Namba 
1   Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
,
Kazuhiko Kabe 
1   Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Recent studies have shown favorable outcomes for intra-abdominal umbilical vein varices (IUVVs) in term neonates who have no other complications. Little is known, however, about the prognosis of IUVVs in preterm neonates. We encountered a case of IUVV in an extremely low-birth-weight infant who developed severe consumptive coagulopathy after birth. The patient's coagulation test normalized as the varix spontaneously obstructed. Although life-threatening hemorrhagic complications were avoided, a cerebellum hemorrhage was found in the brain magnetic resonance imaging at the term-equivalent age. In a literature survey, coagulopathy was reported in 4 out of 15 infants with IUVVs born before 34 weeks of gestation, including our present case. Preterm infants with IUVVs may develop coagulopathy because of the prematurity of their coagulation–fibrinolysis systems. Attention should be given to the coagulation status of preterm neonates with IUVVs.

Keywords

intra-abdominal umbilical vein varix - consumptive coagulopathy - extremely-low-birth-weight infants - intracranial hemorrhages

Informed Consent

Informed consent was obtained from the patient's parents for the publication of this case report and any accompanying images.


Disclosure

The authors declare that they have no known competing financial interests or personal relationships that could influence the work reported in this paper.




Publikationsverlauf

Eingereicht: 13. Januar 2021

Angenommen: 15. Februar 2021

Artikel online veröffentlicht:
27. Mai 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Jodi S, Dashe BLH. Ultrasound evaluation of the placenta, membranes, and umbilical cord. In: Mary E, Norton LMS, Vickie FeldsteinA. eds. Callen's Ultrasonography in Obstetrics and Gynecology, 6th edition. Philadelphia: Elsevier; 2017: 674-703
    Google Scholar
  • 2 Sepulveda W, Mackenna A, Sanchez J, Corral E, Carstens E. Fetal prognosis in varix of the intrafetal umbilical vein. J Ultrasound Med 1998; 17 (03) 171-175
    CrossrefPubMedGoogle Scholar
  • 3 Fung TY, Leung TN, Leung TY, Lau TK. Fetal intra-abdominal umbilical vein varix: what is the clinical significance?. Ultrasound Obstet Gynecol 2005; 25 (02) 149-154
    CrossrefPubMedGoogle Scholar
  • 4 Mahony BS, McGahan JP, Nyberg DA, Reisner DP. Varix of the fetal intra-abdominal umbilical vein: comparison with normal. J Ultrasound Med 1992; 11 (02) 73-76
    CrossrefPubMedGoogle Scholar
  • 5 Batton DG, Amanullah A, Comstock C. Fetal schistocytic hemolytic anemia and umbilical vein varix. J Pediatr Hematol Oncol 2000; 22 (03) 259-261
    CrossrefPubMedGoogle Scholar
  • 6 Rahemtullah A, Lieberman E, Benson C, Norton ME. Outcome of pregnancy after prenatal diagnosis of umbilical vein varix. J Ultrasound Med 2001; 20 (02) 135-139
    CrossrefPubMedGoogle Scholar
  • 7 Viora E, Sciarrone A, Bastonero S. et al. Anomalies of the fetal venous system: a report of 26 cases and review of the literature. Fetal Diagn Ther 2004; 19 (05) 440-447
    CrossrefPubMedGoogle Scholar
  • 8 Fung TY, Chan LW, Leung TY, Lau TK. Gastroschisis associated with an intra-abdominal umbilical vein varix: a report of 2 cases. Fetal Diagn Ther 2009; 25 (04) 404-406
    CrossrefPubMedGoogle Scholar
  • 9 Vanrykel K, Bruneel E, Van Hoestenberghe MR, Buekenhout L, Gyselaers W, Theyskens C. Neonatal disseminated intravascular coagulation after thrombosis of a fetal intra-abdominal umbilical vein varix. J Obstet Gynaecol 2010; 30 (03) 315
    CrossrefPubMedGoogle Scholar
  • 10 Huber G. Title page - intrahepatic umbilical vein varix with postnatal complication in the newborn. Ultraschall Med 2010; 31 (01) 1-3
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 11 Ismail H, Chang YL, Chang SD, Nusee Z. Fetal intra-abdominal umbilical vein varix in monochorionic twins: is it significant?. Malays J Med Sci 2012; 19 (03) 69-73
    PubMedGoogle Scholar
  • 12 Kuwata T, Matsubara S. Another “double bubble” sign or “double bladder” sign: fetal intra-abdominal umbilical vein varix. J Med Ultrason (2001) 2011; 38 (04) 243
    CrossrefPubMedGoogle Scholar
  • 13 Rosenblatt J, Loberstajn A, Coulomb A. et al. Intra-abdominal umbilical vein varix associated with fetal cardiac failure: a pitfall to the prenatal diagnosis of α-zero-thalassemia. Fetal Diagn Ther 2013; 34 (01) 59-62
    CrossrefPubMedGoogle Scholar
  • 14 Ikeda M, Ueda A, Ueda A, Kawahara S, Fukuhara K, Hasegawa M. A case of foetal intra-abdominal umbilical vein varix with adjacent extra-abdominal vein constriction. J Obstet Gynaecol 2017; 37 (08) 1093-1095
    CrossrefPubMedGoogle Scholar
  • 15 Monagle P. Developmental hemostasis. In: Polin RA, Abman SH, Rowitch DH, Benitz WE, Fox WW. eds. Fetal and Neonatal Physiology. Fifth edition. Vol 2. Philadelphia, PA: Elsevier; 2017: 1151-1158
    CrossrefGoogle Scholar