title: HDlive imaging of intra-amniotic umbilical vein varix with thrombosis.
abstract: We present a case of intra-amniotic umbilical vein varix with thrombosis using conventional two-dimensional (2D) sonography, power Doppler, three-dimensional (3D) HD-flow, and HDlive at 35 weeks of gestation. 2D sonography showed a large banana-like umbilical cord enlargement (100 × 43.3 × 45.9 mm) including umbilical vein varix (maximum vein diameter = 25.5 mm) with massive thrombosis. Power Doppler and 3D HD-flow revealed bidirectional turbulent blood flow inside the varix. The HDlive clearly demonstrated fragile massive thrombosis inside the varix. Elective cesarean section was performed on the same day in order to avoid additional risks of umbilical cord complications and umbilical venous embolism. A male infant weighing 2501 g was delivered with an umbilical artery pH of 7.334, and Apgar score of 8/9 at 1 and 5 min, respectively. The macroscopic and microscopic findings revealed umbilical cord vein varix with thrombosis. On the basis of the laboratory date of the neonate, the diagnosis of consumptive coagulopathy was made. However, the neonate followed a favorable course after delivery.
authors.affiliation: Department of Perinatology and Gynecology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kanenishi
authors.forename: E
authors.initials: E
authors.lastname: Nitta
authors.forename: M
authors.initials: M
authors.lastname: Mashima
authors.forename: U
authors.initials: U
authors.lastname: Hanaoka
authors.forename: K
authors.initials: K
authors.lastname: Koyano
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Hata
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D021621:Imaging, Three-Dimensional; D050498:Live Birth; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012720:Severity of Illness Index; D013927:Thrombosis / Q000209:etiology*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins / Q000000981:diagnostic imaging*; D014648:Varicose Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: 3D ultrasound; Antenatal diagnosis; HD-flow; HDlive; Intra-amniotic umbilical vein varix; Power Doppler; Thrombosis