Fetal Umbilical Vein Varix Protocol

• Definition: An umbilical vein varix is a focal dilation of the intra-abdominal umbilical vein.

• Diagnosis: A focal dilation of the intra-abdominal portion of the umbilical vein that measures > 9mm or at least 50% wider than the section of the intra-hepatic umbilical vein.

o Measure on axial image of fetal abdomen.

 Inner edge to inner edge.

• A level 3 ultrasound and fetal echocardiogram should be performed if not already done in the pregnancy.

• An MFM consult should be scheduled within 2 weeks to confirm and discuss the finding.

• Twice weekly BPP should be performed from time of diagnosis until delivery.

• Once weekly evaluation of the varix.

• Central Dopplers.

o Ductus Venosus

o MCA

• Evaluation of the varix should include:

• Color Doppler imaging evaluating for presence of intraluminal thrombus or turbulent flow.

• Measurement of varix.