102 - Cord Cyst

Abstract

Cysts of the umbilical cord have been reported in all trimesters. The clinical significance and prognosis of cord cysts vary depending on the gestational age at diagnosis, persistence of the cyst, and associated structural or chromosomal abnormalities. Most cysts that are diagnosed in early pregnancy disappear by 14 weeks' gestation and are not associated with an adverse pregnancy outcome. Umbilical cord cysts that persist into the second and third trimester of pregnancy, however, are associated with fetal aneuploidy or fetal structural defects. On ultrasound (US), cord cysts have the appearance of anechoic structures located within the fetal umbilical cord. They can occur as a solitary lesion or as multiple lesions, and they do not demonstrate evidence of flow during color Doppler US. The differential diagnosis of this finding includes true cysts, pseudocysts, allantoic cysts, and hematomas. Both true cysts and pseudocysts that persist in the second and third trimesters are associated with congenital anomalies and aneuploidy. Thus the US finding of a cord cyst should prompt a thorough search for other malformations. A cord cyst detected in the first trimester should be reassessed with US examination in the second trimester. Although there are currently no prenatal or postnatal treatment options for fetuses with umbilical cord cysts, the prognosis for fetuses with this finding, in the absence of additional US or chromosomal abnormalities, is excellent.