Prenatal diagnosis of umbilical cord hemangioma

Umbilical cord hemangioma and pseudocyst with favorable fetal outcome

Key Clinical Message

There is a high association between umbilical cord hemangiomas or cysts with fetal mortality. However, favorable outcome is possible with proper prenatal monitoring and care.

Abstract

Umbilical cord hemangiomas are rare neoplasms of vascular origin, commonly found in the free section of the umbilical cord proximal to placental insertion. They are associated with an increased risk of fetal mortality. We present a rare co-occurrence of an umbilical cord hemangioma and a pseudocyst managed conservatively, with favorable fetal outcome despite the interval increase in size, decreased caliber of the umbilical arteries, and fetal chest compression.

Placental and Umbilical Cord Anomalies Diagnosed by Two- and Three-Dimensional Ultrasound

The aim of this review is to present a wide spectrum of placental and umbilical cord pathologies affecting the pregnancy. Placental and umbilical cord anomalies are highly associated with high-risk pregnancies and may jeopardize fetal well-being in utero as well as causing a predisposition towards poor perinatal outcome with increased fetal and neonatal mortality and morbidity. The permanent, computerized perinatology databases of different international centers have been searched and investigated to fulfil the aim of this manuscript. An extended gallery of prenatal imaging with autopsy correlation in specific cases will help to provide readers with a useful iconographic tool and will assist with the understanding and definition of this critical obstetrical and perinatological issue.

Large Angiomyxoma of the Umbilical Cord-Uncomplicated Rupture of Tumor Membranes at 32 Weeks of Gestation

Background: When a tumor of the umbilical cord is prenatally visualized, it is possible to propose the diagnosis depending on the sonographic appearance of the tumor. Angiomyxoma of the umbilical cord appears as a complex solid-cystic mass that is made of angiomatous component and myxoid stroma. When the tumor is diagnosed, serial ultrasound and doppler examinations are used to monitor the tumor’s size and the overall fetal well-being including doppler investigations and fetal growth. Angiomyxomas are not associated with fetal chromosomal pathologies. The cases of intrauterine rupture and fetal death was described in the literature. Case presentation: A 28 years-old pregnant woman was referred to our clinic for second opinion because of visualized umbilical cord tumor during second trimester ultrasound screening. The tumor gradually increased in size until 34th week of gestation, when the rupture of the cystic component was observed. The fetal doppler studies was normal during the course of pregnancy, we observed decreased AC and decreased estimated fetal weight. At the gestational age of the 37 weeks the labor was induced and heathy male infant was born. Conclusions: For the first time to our knowledge, we demonstrate the case of uncomplicated rupture of the cystic component of the angiomyxoma that lead to the possibility to manage the pregnancy conservatively without any compromise of the fetus.