Diagnosis of an Umbilical Vein Aneurysm at 30 Weeks Gestation

BACKGROUND: Fetal umbilical vein aneurysm is an uncommon anomaly without clear guidelines regarding the management of these pregnancies. Case Presentation. We describe an ultrasound diagnosis of this condition involving a 38-year-old multigravid woman who presented at 30 weeks and 3 days gestation with severe fetal growth restriction, reverse end-diastolic flow on umbilical artery dopplers, elevated ductus venosus doppler, and an umbilical vein aneurysm. Due to nonreassuring fetal assessment in the setting of an umbilical vein aneurysm, she underwent a cesarean delivery with a favorable neonatal outcome. CONCLUSIONS: There are currently no guidelines for the management of an umbilical vein aneurysm. This case demonstrates a successful multidisciplinary approach for creating a plan of care focused on achieving a favorable outcome for a fetus with a large umbilical vein aneurysm. The approach took into account timing of delivery given the potential for fetal morbidity and mortality, while factoring in the risk of prematurity.