Persistent right umbilical vein: its incidence and clinical importance

Ebru ÇELİK KAVAK,Salih Burçin KAVAK,Cengiz ŞANLI,Gülay BULU,İbrahim BATMAZ,Seren ÖZDEN,Hasan Burak KESER

Abstract

Objective: To investigate the incidence and concomitant findings of persistent right umbilical vein (PRUV). Methods: The study was conducted by retrospective review of the data of 1856 patients who admitted to the Clinic of Obstetrics and Gynecology of F›rat University between December 2018 and December 2019 for the gestational examination between 14 and 28 weeks of gestation. The obstetric characteristics of the patients such as age, number of pregnancy, abortion, parity and body mass index were recorded. The diagnosis of PRUV was established in the conditions where portal vein reaches to stomach abnormally (roughly, course towards stomach instead of parallel course), fetal gall bladder locates in the medial of umbilical vein or umbilical vein connects to right portal vein abnormally instead of left portal vein. In the cases diagnosed with PRUV, the isolated persistent right umbilical vein or its association with other anomalies was recorded. Ultrasonography findings (minor markers) were also recorded in these cases. Results: During the study period, 1856 pregnant women were evaluated for gestational examination. Five cases were established with the diagnosis of PRUV. Accordingly, PRUV prevalence was 0.27%. The PRUV incidence in the study population was 1/370 in the study population. No chromosomal anomaly was found in PRUV cases, but one case had echogenic intracardiac focus, one case had echogenic intestine, and one case had short nasal bone. When organ systems were evaluated, renal cyst was found in one case. No additional finding was found in one case. Conclusion: PRUV is the most common form among fetal venous system anomalies. If detected, fetal examination is required in terms of the anomalies that may accompany. Chromosome analysis is not necessary if it is isolated, and it should be evaluated as a variant of normal anatomy.

Özet

Amaç: Persiste sa¤ umbilikal ven (PSUV) görülme s›kl›¤› ve efllik eden bulgular›n incelenmesi. Yöntem: Çal›flma Aral›k 2018 ile Aral›k 2019 tarihleri aras›nda F›- rat Üniversitesi Kad›n Hastal›klar› ve Do¤um Poliklini¤i’ne 14–28. gebelik haftalar›nda gebelik muayenesi için baflvuran 1856 hastan›n verilerinin retrospektif incelenmesi ile yap›ld›. Hastalar›n yafl, gebelik say›s›, abortus, parite ve vücut kitle indeksi gibi obstetrik özellikleri kay›t alt›na al›nd›. PSUV tan›s› için; portal venin mideye do¤ru anormal flekilde uzanmas› (kabaca paralel seyir yerine mideye do¤ru seyir), fetal safra kesesinin umbilikal venin medialinde yer almas› veya umbilikal venin sola de¤il, anormal olarak sa¤ portal vene ba¤lanmas›n›n izlenmesi ile tan› konuldu. PSUV tespit edilen olgularda, persiste sa¤ umbilikal venin izole veya di- ¤er anomalilerle olan birlikteli¤i kay›t edildi. Bu olgularda di¤er ultrasonografi bulgular› (minör belirteçler) da kay›t alt›na al›nd›. Bulgular: Çal›flman›n yap›ld›¤› tarihler aras›nda, gebelik muayenesi için 1856 gebe de¤erlendirildi. Befl olguda PSUV tan›s› konuldu. Buna göre PSUV görülme s›kl›¤› %0.27 olarak tespit edildi. Çal›flma popülasyonda PSUV insidans› 1/370 olarak bulundu. PSUV olgular›nda kromozom anomalisine rastlanmam›fl olup, bir olguda intrakardiyak ekojenik odak, bir olguda ekojen barsak, bir olguda k›sa nazal kemik izlendi. Organ sistemleri de¤erlendirildi¤inde bir olguda renal kist saptand›. Bir olguda ise herhangi bir ek bulguya rastlanmad›. Sonuç: PSUV, fetal venöz sistem anomalileri içinde en s›k görülen formdur. Tespiti halinde efllik edebilecek anomaliler aç›s›ndan dikkatli fetal muayene gerekir. ‹zole olmas› halinde kromozom incelemesini gerektirmez; normal anatominin bir varyant› olarak de- ¤erlendirilmelidir