Intra Abdominal Umbilical Vein Varix, What Does It Mean?

At our 31 week appointment the CNM heard an irregularity with baby’s heartbeat so we were sent to the perinatologist, a high risk doctor. While we were there we discovered our baby has an intra abdominal umbilical vein varix.

An intra abdominal umbilical vein varix is defined as focal dilatation of the umbilical venous diameter at the level of cord insertion. Basically a portion of the umbilical cord is bigger than it should be. What are the ramifications of this? We do not really know. It is a pretty rare thing to have. Most babies who have an intra abdominal umbilical vein varix are not diagnosed because it often does not show up at the 20 week anatomy scan. Had our babies heartbeat been normal we never would have done an in depth ultrasound at 31 weeks and would not have discovered the intra abdominal umbilical vein varix.

There is one study that was performed in 1992 which suggests delivering the baby between 32-34 weeks. This would be NOW. Scary. Since 1992 (the study was on 7 babies. Yes SEVEN.) there have been more documented cases of intra abdominal umbilical vein varix and the recommendation is to let baby stay in until 36-39 weeks. The studies that have been done in more recent years show, as long as the pregnancy is progressing well and the intra abdominal umbilical vein varix has not changed, there is no need to induce.

There is a lot of non information regarding intra abdominal umbilical vein varix. Again, it is very rare and not highly documented. In my opinion, most of the studies are biased as the infants in the studies are sickly. We would not have known about the intra abdominal umbilical vein varix if our baby’s heart rate was fine. The infants in the studies typically have more problems than just the intra abdominal umbilical vein varix.

It is really frustrating, the lack of information. Our high risk doctor told us we could deliver now if we wanted to, or we could wait until baby comes on his own, as long as everything is progressing normally. Naturally we opted to let baby stay in. As long as he is doing well inside we will not force him to be born. I am not high risk, I do not need to see a high risk doctor. I am able to go to my regular doctor for all of my regularly scheduled appointments. The intra abdominal umbilical vein varix could be a big deal but it could also be nothing. It is interesting how little information there is. And how there is no clear direction on where to go and what to do.

I am not high risked out of a home birth. There is nothing, right now, that needs to change in our birth plan.

When an intra abdominal umbilical vein varix is found at the 2o week anatomy scan it is typically a more dire situation. Since ours was not found until 31 weeks there is a good chance everything will be okay and this will just be something to monitor.

What are we doing, how are we addressing this issue? I am going to bi-weekly non stress tests (HA! Anyone who has done a NST knows how stressful they are.) with an in depth ultrasound every other week to make sure the intra abdominal umbilical vein varix has not changed and there are no clots in the umbilical cord. As long as the umbilical cord is working well, baby is fine. Once baby is born, the umbilical cord is no longer an issue. There is nothing that needs to be done once baby is born.

Below are links to studies. These studies may not provide you with all the information you are seeking. There is not a lot of information on intra abdominal umbilical vein varix because it is so rare and so rarely documented. Had this pregnancy progressed normally without any heart rate issues we may never have know about it.

http://www.dovemed.com/diseases-conditions/umbilical-cord-varix/

http://www.sciencedirect.com/science/article/pii/S2211568414000102

https://www.ncbi.nlm.nih.gov/pubmed/21266567


What do you think?