Published online Nov 27, 2021. doi: 10.4254/wjh.v13.i11.1802
Peer-review started: March 21, 2021
First decision: August 18, 2021
Revised: August 31, 2021
Accepted: October 14, 2021
Article in press: October 14, 2021
Published online: November 27, 2021
The use of umbilical venous catheters (UVCs) in the perinatal period may be associated with severe complications, including the occurrence of portal vein thrombosis (PVT).
Although multiple observational studies have provided an overview about the risk of PVT after UVC positioning, no studies/reviews explored systematically this issue.
The main goal was to investigate the most accurate information about the actual incidence of UVC-related PVT in the neonatal setting, and to assess if any particular risk factor was systematically associated with the development of such complication.
A systematic and comprehensive database searching (PubMed, Cochrane Library, Scopus, Web of Science) was performed for prospective cohort studies, retrospective cohort studies and case-control studies from 1980 to 2020. Incidence estimates were pooled by using random effects meta-analyses. The quality of included studies was assessed using the Newcastle-Ottawa scale.
Sixteen studies were considered eligible and included in the final analyses. The data confirmed the relevant risk of UVC-related thrombosis with a mean pooled incidence of 12%, although it varied across studies (0%-49%).
This is the first systematic review specifically investigating the incidence of UVC-related PVT. The use of UVCs requires a high index of suspicion, because its use is significantly associated with PVT.
Large prospective randomized studies and updated guidelines are warranted in order to define the best management of this dreaded complication.