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What is the prevalence of portal vein thrombosis following umbilical venous catheter insertion in very preterm neonates?
  1. Nikitha Rajaraman1,
  2. Tim J van Hasselt2
  3. Paediatric Research Across the Midlands (PRAM) Network
  1. 1 Paediatrics and Neonatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2 Neonatal Intensive Care, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Nikitha Rajaraman, Paediatrics and Neonatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK; nikitha12.rajaraman{at}

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While working on a neonatal unit, you look after a baby born at 28 weeks gestational age, who required umbilical venous catheter (UVC) insertion following birth. During a routine echocardiogram examination to assess the patent ductus arteriosus, an incidental finding of an echogenic, non-occlusive thrombus was identified in the left portal vein. This was thought to be secondary to the UVC placement.

You wonder how many preterm babies who have UVCs inserted in the neonatal unit develop portal venous thrombosis and who have complications from this.

Structured clinical question

What is the prevalence of portal vein thrombosis following UVC insertion in preterm neonates born ≤32 weeks or very low birthweight infants (<1500 grams)? What is the prevalence of long-term significant complications of this?


We searched MEDLINE, Embase and CINAHL databases using the Ovid interface, limiting to articles published after 1990, using the following search strategy: (“Neonate” OR “newborn” or “neonatal” OR “neonatal intensive care unit” OR “newborn intensive care unit” OR “NICU” OR “premature” OR “prematurity” OR “preterm” OR “extremely premature” OR “low birth weight” OR “extremely low birth weight” OR “very low birth weight” OR “LBW” OR “VLBW”) AND (“Umbilical venous catheter” OR “umbilical venous line” OR umbilical venous access” OR “UVC”) AND (“Thrombus” OR “liver vein thrombus” OR “portal vein thrombus” OR “thrombi” OR “blood clot” OR “blood clotting” OR “portal hypertension” OR “conjugated bilirubinaemia” OR “conjugated hyperbilirubinaemia” OR “neonatal hepatitis” OR “hepatic abscess” OR “death” OR “mortality” OR “liver injury” OR “hepatic injury”). We performed the search in January 2023.

A total of 224 articles were found from the search. Nine systematic review articles were found, and an additional four references from these were screened. We excluded case studies or case series. Conference abstracts were included if they included sufficient information to answer the research question. Studies were included if …

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  • Contributors NR initiated the project, formed the clinical question and completed the literature search. Both NR and TJvH independently reviewed the titles, abstracts and full-text articles. NR wrote the manuscript. TJvH proof-read a few drafts and with further input strengthened the quality of the article. PRAM connects paediatric trainees with research interests across the West Midlands Region to allow for collaboration in projects, including evidence reviews.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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