Fetal Tricuspid Annular Plane Systolic Excursion in the Surveillance of Intra-Abdominal Umbilical Vein Varix

To describe the application of tricuspid annular plane systolic excursion (TAPSE) in monitoring cardiac function in cases of fetal intra-abdominal umbilical vein varix (FIUVV).

The sample consisted of all cases of FIUVV diagnosed in a tertiary medical center between 2018 and 2023 that were assessed by sonographic fetal TAPSE. Cases were identified by retrospective database review. Data on maximal umbilical vein varix diameter, associated anatomic or genetic anomalies, and pregnancy outcomes were collected from the electronic files.

Seventeen cases met the inclusion criteria; 13/17 (76.5%) had isolated FIUVV. The mean maximal varix diameter was 12.6 ± 2.1 mm. In 14/17 cases (82.4%), TAPSE was above the 75th percentile, including 10/17 (58.8%) in which TAPSE measured above the 90th percentile. There were no instances of thrombosis formation or intrauterine fetal demise.

Our findings suggest a hyperdynamic cardiac state in fetuses with FIUVV. Fetal TAPSE may serve as a complementary tool in the surveillance of these cases, potentially aiding in the early identification of cardiac decompensation and guiding the optimal timing of delivery.