Case Report


Prenatal diagnosis of a fetal inferior vena cava thrombus

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1 Medical Student, Medical College of Wisconsin, Milwaukee, Wisconsin, United States

2 Physician Fellow, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States

3 Sonographer, Maternal Fetal Care Center, Froedtert Hospital, Milwaukee, Wisconsin, United States

4 Attending Physician, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States

Address correspondence to:

Emily Fahl

Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, Wisconsin 53226,

United States

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Article ID: 100114Z08EF2022

doi: 10.5348/100114Z08EF2022CR

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How to cite this article

Fahl E, Livergood MC, Penzkover D, Peterson E. Prenatal diagnosis of a fetal inferior vena cava thrombus. J Case Rep Images Obstet Gynecol 2022;8: 100114Z08EF2022.

ABSTRACT


Introduction: Diagnosis and management of fetal thrombosis during pregnancy is rare. Few cases of prenatally diagnosed inferior vena cava thrombi are reported and often occur with renal vein thrombi. Several maternal and fetal risk factors have been identified, including thrombophilias.

Case Report: Patient is a 39-year-old G6P2123 with heterozygous Factor V Leiden with a prenatally diagnosed fetal inferior vena cava thrombus at 34 weeks of gestation during antenatal ultrasound. Her peripartum course was uncomplicated. On day 1 of life, neonatal ultrasound and computed tomography confirmed the presence of thrombus. On day 7, the neonate underwent a thrombectomy for definitive management due to risk of embolization.

Conclusion: While ultrasound is not routinely used for screening for fetal thromboses, when thrombosis is diagnosed, antenatal management is complex, weighing fetal and maternal risks and benefits. Thrombectomy as definitive thrombus management is an appropriate treatment when risk of embolization exists. Imaging modalities are useful for both diagnosis and management of fetal thrombi.

Keywords: Fetal thrombus, Fetal ultrasound, Prenatal diagnosis, Prenatal ultrasound

SUPPORTING INFORMATION


Author Contributions

Emily Fahl - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Mary Christine Livergood - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Deborah Penzkover - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Erika Peterson - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2022 Emily Fahl et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.