EP06.56: The role fetal TAPSE in the surveillance of intra‐abdominal umbilical vein varix

The significance of fetal intra-abdominal umbilical vein varix (FIUVV) remains unclear. Prior studies have indicated an association with fetal demise, leading to debate over the management of pregnancy and the timing of delivery. One suggested mechanism behind fetal death is cardiac failure due to cardiac overload. This study aims to describe the application of Tricuspid Annular Plane Systolic Excursion (TAPSE) in monitoring cardiac function in fetuses diagnosed with FIUVV. We reviewed all cases of FIUVV diagnosed in a tertiary care centre between 2018 and 2023 with sonographic fetal-TAPSE assessment. Data collected included maximal umbilical vein varix diameter, associated anatomic or genetic anomalies, and pregnancy outcomes. Sixteen cases were included in the study group. The mean maximal varix diameter was 12.6 ± 2.2 mm, with 11 cases presenting isolated FIUVV. In 13/16 fetuses, TAPSE was measured above the 75th percentile, including nine cases above the 90th percentile. No cases of thrombosis formation or intrauterine fetal demise were reported in the study group. In one case (case 9, see figure 1), a decision for labour induction was made at 38+0 weeks following TAPSE percentile regression, considered a preliminary sign of hemodynamic decompensation. Our findings reflect a hyperdynamic cardiac state in fetuses with FIUVV. Fetal TAPSE may serve as a complementary tool in the surveillance of these fetuses, potentially aiding in the early identification of cardiac decompensation and guiding the optimal delivery timing. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.