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Bilateral renal vein and inferior vena cava thrombosis associated with fetal vascular malperfusion and maternal diabetes

Posted by Dr. Kathleen O'Brien on August 20, 2019 in Pediatrics
Figure 1
Figure 1

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Introduction

Fetal vascular malperfusion (FVM), previously known as fetal thrombotic vasculopathy, refers to a group of placental lesions indicating reduced or absent perfusion of the villous parenchyma by the fetus (1) . It has been postulated that the Virchow triad of stasis, hypercoagulability and endothelial damage are contributing factors to the development of FVM (1) . Although the underlying etiology of FVM remains unclear, pre-existing maternal diabetes is a known risk factor. FVM can lead to severely adverse perinatal outcomes, including fetal growth restriction, thromboembolic events and intrauterine fetal demise 234 . We report a case of FVM resulting in bilateral renal vein thrombosis (RVT) with inferior vena cava involvement, presenting as acute nonimmune hydrops fetalis in a moderately preterm infant born to a mother with type 1 diabetes mellitus (T1DM).