Large Umbilical Cord Research Articles

Angiomyxoma – A Rare Finding Associated with Congenital Cyst Malformation of the Umbilical Cord

Although rare, umbilical cord cysts may be associated with prenatal aneuploidy and foetal developmental anomaly. If unresolved, they may affect growth support with a risk of progressive or sudden vascular compromise. In this report, we discuss the case of a 33-year-old woman who presented with a large septate umbilical cord cyst detected incidentally during routine morphology scanning. The patient had low-risk first-trimester combined screening, later confirmed by Non-Invasive Prenatal Testing (NIPT). She went on to have detailed antenatal ultrasound surveillance and delivered successfully at term. The case highlights the importance of multidisciplinary collaboration with tertiary partners to align clinical care with best practices and evidence-based decision-making. This is particularly relevant in regional settings where the workforce may be strained or transient and the knowledge base of rare conditions less robust.

Investigation of human parvovirus B19 prevalence in a large healthy umbilical cord blood donors.

Background and Objectives:Umbilical cord blood (UCB) was used to source hematopoietic stem cells in the past. Despite the apparent advantages of UCB transplantation, virus reactivation poses a considerable danger in allogeneic hematopoietic stem cell transplantation (HSCT). Human Parvovirus B19 is regarded as a potential threat to UCB contamination. This study aimed to evaluate the prevalence of parvovirus B19 in cord blood donors by Semi-Nested PCR. This study is the first largescale report of the B19 DNA in cord blood donors in Iran.Materials and Methods:A total of 691 umbilical cord blood were collected under standard procedure. Then, DNA from buffy coat and plasma were extracted, and semi-nested PCR was performed for all samples.Results:Two out of 691 samples (0.29%) indicated viremia in plasma and buffy coat.Conclusion:In this line, designing and validating a quantitative PCR assay for detection, quantification, and discrimination of Human B19 DNA genotypes of cord blood donors is necessary to enhance the safety of this source of stem cells.

A rare case of Beckwith-Wiedemann syndrome with encephalocele.

Image in medicine A premature female child was delivered with polyhydramnios, an unusually large placenta and long umbilical cord. The clinical examination revealed that there is macrosomia, macroglossia and encephalocele. The patient also had complains of hypoglycemia on 2nd day and on the clinical examination, the patient was diagnosed with a rare case of Beckwith-Wiedemann Syndrome with encephalocele. Figure 1 A) anterior view with macroglossia and macrosomia; B) posterior view with encephalocele

Congenital hernia of the umbilical cord with patent vitello-intestinal duct in a newborn: A rare case

Congenital hernia of the umbilical cord is a less frequent entity in newborns and occasionally associated with other maladies. Sometimes, a large umbilical cord hernia is confused with small omphalocele. We report an unusual case of umbilical cord hernia associated with patent vitello-intestinal duct in a male newborn who underwent surgery and discharged with good general condition.

Umbilical Cord Hernia: Report of an Unusual Case

Congenital umbilical cord hernia is fairly common in infants and it is rarely associated with other anomalies. Sometimes, large umbilical cord hernia is confused with Small omphaloceles. We report an unusual case of umbilical cord hernia associated with patent vitello-intestinal duct (PVID), and Meckel's diverticulum underwent surgery and discharged with good general condition.

Intrauterine fetal death caused by large placental chorioangioma and hypercoiled umbilical cord: A case report

Intrauterine fetal death caused by large placental chorioangioma and hypercoiled umbilical cord: A case report

Case Report: Body Stalk Anomaly

We describe a case of a unique pregnancy of 27 weeks of gestational age, the ultrasound examination revealed a large abdominal-thoracic wall defect and short umbilical cord. These ultrasound findings were diagnosed as Body Stalk Anomaly. The patient begins contractions spontaneously and by hysterotomy an alive baby was born and posteriorly, died in few minutes due to extreme preterm birth and multiple congenital anomalies. The final anatomopathological evaluation confirmed the diagnosis.

P24.01: A large umbilical cord pseudocyst manifesting ductus venosus Doppler abnormality: a case report

P24.01: A large umbilical cord pseudocyst manifesting ductus venosus Doppler abnormality: a case report

Large pseudocyst of the umbilical cord detected in the second trimester.

We present a case of a large umbilical cord cyst detected at 21weeks of gestation. Serial ultrasonographic examination revealed a single umbilical artery and progression of the cystic mass. A 2,842-g male infant was delivered at 37weeks of gestation, and we confirmed that the umbilical cord cyst was a pseudocyst in our pathological examination. This case demonstrated an uneventful course of pregnancy despite the large umbilical cord pseudocyst.

P25.11: The OEIS complex presented with large umbilical cord cyst in early gestation

P25.11: The OEIS complex presented with large umbilical cord cyst in early gestation

Large cross‐sectional area of the umbilical cord as a predictor of fetal macrosomia

To determine whether a large cross-sectional area of the umbilical cord is a predictor of fetal macrosomia. Consecutive patients of > 34 weeks' gestation, who presented for sonographic examination and who delivered within 4 weeks of the examination, were included in the study. The sonographic cross-sectional areas of the umbilical cord, the umbilical vessels and the Wharton's jelly were measured in a free loop of the umbilical cord. Logistic regression analysis was used to determine significant predictors of macrosomia (actual birth weight > 4000 g and > 4500 g). Fetal biometric parameters (biparietal diameter, abdominal circumference and femur length), sonographic estimated fetal weight and umbilical cord area > 95(th) centile for gestational age were used as covariates. During the study period, 1026 patients were enrolled. Fifty-three (5.2%) newborns had a birth weight > 4000 g, and 22 (2.1%) weighed > 4500 g. The proportion of cases with a large umbilical cord was significantly higher in the group of macrosomic compared with non-macrosomic infants (54.7% vs. 8.7%, P < 0.0001). Multiple regression models demonstrated an independent contribution of the large cord in the prediction of birth weight > 4000 g and > 4500 g (odds ratio (95% CI), 20.6 (9.2-45.9) and 4.2 (1.2-17.7), respectively). The sensitivity, specificity and positive and negative predictive values of a sonographic large umbilical cord were 54.7%, 91.3%, 25.4%, and 97.4%, respectively. The combination of abdominal circumference > 95(th) centile and large cord predicted 100% of macrosomic infants. The proportion of umbilical cords with a Wharton's jelly area > 95(th) centile for gestation was significantly higher in macrosomic fetuses of diabetic compared with non-diabetic mothers. Sonographic assessment of umbilical cord area may improve the prediction of fetal macrosomia.

Large Umbilical Cord Hemangioma

Umbilical cord tumors are rare occurrences with various pathologic features, and prenatal differentiation is often very difficult. Familiarity with their existence and their associated anomalies will increase the accuracy of diagnosis and prevent unnecessary interventional procedures before delivery that have the potential risk of fetal mortality. We present a case of maternal preeclampsia associated with a large umbilical cord mass. Postnatal findings confirmed a solid-cord hemangioma and localized cystic degeneration of Wharton jelly.

OC18.03: Just images: Isolated multiple large umbilical cord cysts and thick prominent Wharton's jelly

OC18.03: Just images: Isolated multiple large umbilical cord cysts and thick prominent Wharton's jelly

Umbilical cord entanglement in monoamniotic twins.

Monochorionic–monoamniotic twin pregnancies are a rare obstetric high-risk situation with an estimated frequency of 1 per 25 000 pregnancies. They occur when the division of the morula into two similar totipotent parts takes place between days 9 and 12 after conception. Perinatal mortality is extremely high, ranging between 28% and 70%1. Fetal mortality is caused by prematurity, cord complications and associated congenital anomalies. These days, with the widespread application of sophisticated first-trimester ultrasound, the detection of monoamniotic twin pregnancies can occur earlier and be more precise. Sonographic criteria include single placenta, absence of separating membrane and concordant sex. However, this improved diagnosis has little impact on the regime of surveillance, management and outcome of such pregnancies. While intensive surveillance of monoamniotic twin pregnancies is generally performed, the right time for and mode of delivery are still under discussion. Delivery by Cesarean section at 32 weeks' gestation is recommended by some groups2 in order to avoid intrauterine complications in late pregnancy. However, whether there is excess mortality after 30–32 weeks is questionable. A recent study by Demaria et al.3 of 19 monoamniotic twin pregnancies documented that there were no double fetal deaths after 26 weeks. Delivery of monoamniotic pregnancies by Cesarean section can also help avoid intrapartum accidents of collision and impaction. However, Demaria et al.3 report a 40% rate of uncomplicated vaginal deliveries. The Picture of the Month (Figure 1a) demonstrates prenatal color Doppler imaging of a monoamniotic twin pregnancy in week 26 showing the two very close cord insertions. Under strict surveillance the pregnancy was successfully continued until week 32. Two healthy newborns were delivered via primary Cesarean section after systematic pulmonary maturation. Part (b) illustrates the large umbilical cord entanglement with a very short section of ‘free’ cord in both twins. In this case a cord accident with a tight clinch and entanglement with impaired umbilical perfusion seems probable if the pregnancy had been prolonged. Furthermore, this situation excludes a normal vaginal delivery. In retrospect, a planned Cesarean section in the 32nd week was justified since both newborns showed a normal neonatal adaptation period. (a) Prenatal color Doppler ultrasound image of a monoamniotic twin pregnancy in week 26 showing the two very close cord insertions. (b) Postnatal photograph showing the large umbilical cord entanglement (black arrows) with a very short section of ‘free’ cord (white arrow) in both twins. Knowing that no optimal protocol for the management of monoamniotic pregnancies has been defined, we believe that sonographic investigation and documentation of the umbilical cord may contribute helpful information to the decision-making process.

Omphalocele associated with a large multilobular umbilical cord pseudocyst.

The prevalence of umbilical cord cysts at 7-13 weeks' gestation is approximately 3%. More than 20% of such cases are complicated by structural defects and/or chromosomal abnormalities such as trisomy 18. These cysts usually have a single cavity and are <5 cm in size. Therefore, when an umbilical cord cyst is detected in the 2nd trimester, the examination of fetal karyotype is recommended. Omphaloceles are also well known to be complicated by many anomalies, especially trisomy 18. We report a case of an omphalocele associated with a large multilobular umbilical pseudocyst (diameter >5 cm) in a patient with a normal karyotype, 46XY. These anomalies were diagnosed by fetal ultrasonography. However, the cyst was difficult to diagnose as an umbilical cord pseudocyst because it was very large and multilobulated. At 38.5 weeks of gestation, the patient was delivered by Cesarean section. The cyst was resected, and the omphalocele was closed by staged surgeries. Pathologic diagnosis of the cyst was the degeneration of Wharton's jelly. This diagnosis was made by the absence of epithelial lining inside the cyst wall, since the existence of epithelial cells correlates with true cysts.

Sonographic diagnosis of a large umbilical cord pseudocyst.

Journal of Ultrasound in MedicineVolume 13, Issue 6 p. 487-489 Case Reports Sonographic diagnosis of a large umbilical cord pseudocyst. C S Kalter, C S Kalter Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this authorM C Williams, M C Williams Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this authorV Vaughn, V Vaughn Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this authorW N Spellacy, W N Spellacy Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this author C S Kalter, C S Kalter Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this authorM C Williams, M C Williams Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this authorV Vaughn, V Vaughn Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this authorW N Spellacy, W N Spellacy Department of Gynecology, Harbor Side Medical Towers, Tampa, FL 33606Search for more papers by this author First published: 01 June 1994 https://doi.org/10.7863/jum.1994.13.6.487Citations: 15AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume13, Issue6Jun 1994Pages 487-489 RelatedInformation

Osmolar relationship between enlarged umbilical cord and patent urachus

A case of neonatal patent urachus with an enlarged umbilical cord is reported. The relationship between patent urachus and umbilical cord swelling was studied experimentally. It was concluded that reflux of urine through the patent urachus can cause umbilical cord swelling. Consequently, a patent urachus must be suspected in the presence of an abnormally large umbilical cord. Just before submitting this report, a 24-hour-old male admitted with imperforate anus had a large umbilicus, which, on failing to heal, was found to be the site of a draining urachus (Fig. 2AB). His umbilical cord was known to be excessively large.