Cargando…

Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies

BACKGROUND: Persistent right umbilical vein (PRUV) is characterized by atresia of the left umbilical vein while the right umbilical vein remains open. Given the limited sample size of most studies, the incidence of PRUV and the status of concomitant anomalies may not be fully reflected. Thus, we stu...

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Jingyu, Yuan, Qian, Ding, Hao, Yang, Zeyu, Wang, Bing, Wang, Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547413/
https://www.ncbi.nlm.nih.gov/pubmed/33036561
http://dx.doi.org/10.1186/s12884-020-03310-2
_version_ 1783592414731042816
author Li, Jingyu
Yuan, Qian
Ding, Hao
Yang, Zeyu
Wang, Bing
Wang, Bin
author_facet Li, Jingyu
Yuan, Qian
Ding, Hao
Yang, Zeyu
Wang, Bing
Wang, Bin
author_sort Li, Jingyu
collection PubMed
description BACKGROUND: Persistent right umbilical vein (PRUV) is characterized by atresia of the left umbilical vein while the right umbilical vein remains open. Given the limited sample size of most studies, the incidence of PRUV and the status of concomitant anomalies may not be fully reflected. Thus, we studied the incidence of fetal PRUV and its concomitant anomalies on a larger scale using our hospital database. This study hoped to address the following questions: Does PRUV increase the risk of fetal anomalies? If the PRUV fetus also has a single umbilical artery (SUA), does the risk of fetal anomaly increase further? What is the positive predictive value of PRUV for fetal anomalies? METHODS: This retrospective study analyzed 756 cases of fetal PRUV at our hospital from January 2007 to April 2017. Prenatal ultrasound and color Doppler images were assessed. All PRUV fetuses underwent echocardiography and detailed ultrasound examinations of other systems. Newborn status was obtained via the database or by telephone follow-up. RESULTS: A total of 435,428 pregnant women underwent prenatal ultrasonography at 16–40 weeks, the incidence of fetal PRUV was 0.17%, and 102 fetuses (13.5%) developed other anomalies. Two complicated cases had trisomy 18. PRUV was associated with a higher incidence of fetal anomalies. When fetal anomalies were classified by body systems, PRUV was associated with a higher incidence of cardiovascular, nervous, urinary, skeletal, digestive, and respiratory system anomalies. The positive predictive values of a PRUV for any fetal anomalies and cardiovascular anomalies were 13.5% (95%CI, 11.2–16.2%) and 5.4% (95%CI, 4.0–7.3%), respectively. SUA further increases the risk of PRUV fetuses with other anomalies and cardiovascular anomalies. CONCLUSIONS: Detailed prenatal ultrasonography and echocardiography should be performed in fetuses with PRUV to rule out anomalies in other systems. When the PRUV is combined with SUA, echocardiography is particularly important. Fetuses with complicated PRUV should undergo chromosomal examination. Although isolated fetal PRUV prognosis is good, complicated PRUV prognosis depends on the type and severity of the concomitant anomalies.
format Online
Article
Text
id pubmed-7547413
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-75474132020-10-13 Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies Li, Jingyu Yuan, Qian Ding, Hao Yang, Zeyu Wang, Bing Wang, Bin BMC Pregnancy Childbirth Research Article BACKGROUND: Persistent right umbilical vein (PRUV) is characterized by atresia of the left umbilical vein while the right umbilical vein remains open. Given the limited sample size of most studies, the incidence of PRUV and the status of concomitant anomalies may not be fully reflected. Thus, we studied the incidence of fetal PRUV and its concomitant anomalies on a larger scale using our hospital database. This study hoped to address the following questions: Does PRUV increase the risk of fetal anomalies? If the PRUV fetus also has a single umbilical artery (SUA), does the risk of fetal anomaly increase further? What is the positive predictive value of PRUV for fetal anomalies? METHODS: This retrospective study analyzed 756 cases of fetal PRUV at our hospital from January 2007 to April 2017. Prenatal ultrasound and color Doppler images were assessed. All PRUV fetuses underwent echocardiography and detailed ultrasound examinations of other systems. Newborn status was obtained via the database or by telephone follow-up. RESULTS: A total of 435,428 pregnant women underwent prenatal ultrasonography at 16–40 weeks, the incidence of fetal PRUV was 0.17%, and 102 fetuses (13.5%) developed other anomalies. Two complicated cases had trisomy 18. PRUV was associated with a higher incidence of fetal anomalies. When fetal anomalies were classified by body systems, PRUV was associated with a higher incidence of cardiovascular, nervous, urinary, skeletal, digestive, and respiratory system anomalies. The positive predictive values of a PRUV for any fetal anomalies and cardiovascular anomalies were 13.5% (95%CI, 11.2–16.2%) and 5.4% (95%CI, 4.0–7.3%), respectively. SUA further increases the risk of PRUV fetuses with other anomalies and cardiovascular anomalies. CONCLUSIONS: Detailed prenatal ultrasonography and echocardiography should be performed in fetuses with PRUV to rule out anomalies in other systems. When the PRUV is combined with SUA, echocardiography is particularly important. Fetuses with complicated PRUV should undergo chromosomal examination. Although isolated fetal PRUV prognosis is good, complicated PRUV prognosis depends on the type and severity of the concomitant anomalies. BioMed Central 2020-10-09 /pmc/articles/PMC7547413/ /pubmed/33036561 http://dx.doi.org/10.1186/s12884-020-03310-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Li, Jingyu
Yuan, Qian
Ding, Hao
Yang, Zeyu
Wang, Bing
Wang, Bin
Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
title Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
title_full Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
title_fullStr Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
title_full_unstemmed Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
title_short Ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
title_sort ultrasonic detection of fetal persistent right umbilical vein and incidence and significance of concomitant anomalies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547413/
https://www.ncbi.nlm.nih.gov/pubmed/33036561
http://dx.doi.org/10.1186/s12884-020-03310-2
work_keys_str_mv AT lijingyu ultrasonicdetectionoffetalpersistentrightumbilicalveinandincidenceandsignificanceofconcomitantanomalies
AT yuanqian ultrasonicdetectionoffetalpersistentrightumbilicalveinandincidenceandsignificanceofconcomitantanomalies
AT dinghao ultrasonicdetectionoffetalpersistentrightumbilicalveinandincidenceandsignificanceofconcomitantanomalies
AT yangzeyu ultrasonicdetectionoffetalpersistentrightumbilicalveinandincidenceandsignificanceofconcomitantanomalies
AT wangbing ultrasonicdetectionoffetalpersistentrightumbilicalveinandincidenceandsignificanceofconcomitantanomalies
AT wangbin ultrasonicdetectionoffetalpersistentrightumbilicalveinandincidenceandsignificanceofconcomitantanomalies