Objective:
To explore the
prognosis of
umbilical cord cysts in
fetuses with structural
abnormalities diagnosed by
prenatal ultrasonography.
Methods:
This
retrospective study involved 109 cases of
umbilical cord cysts diagnosed by ultrasound at
Beijing Obstetrics and
Gynecology Hospital from January 2016 to December 2020. According to the ultrasound findings, these cases were divided into the isolated
umbilical cord cyst, umbilical cord
cyst with soft ultrasound markers, and
umbilical cord cyst with
fetal malformation groups. Chi-square was performed for
statistical analysis to compare the
prognosis.
Results:
(1) Among 109 cases of
umbilical cord cysts, 55 cases (50.5%) were isolated, 20 (18.3%) were complicated by soft ultrasound markers, and 34 (31.2%) cases were complicated by
fetal malformation. After excluding two cases of multiple
cysts at different locations, the
incidence of
umbilical cord cysts at the placental end, free segment, and fetal terminal with other ultrasound
abnormalities in the remaining 107 cases increased sequentially [27.5% (14/51), 10/17, and 76.9% (30/39), χ2=22.20, P<0.001]. The
incidence of
umbilical cord cysts with other ultrasound
abnormalities at the fetal end was higher than at the placental end ( χ2=21.65, P<0.001). (2) A total of 60
fetal malformations were detected, dominated by fetal
ventricular septal defect,
omphalocele, giant
bladder,
fetal edema, and nuchal
cystic hygroma, et al., mainly involving the
cardiovascular system,
urogenital system, anterior
abdominal wall, and skeletal system. (3) Eighty-nine cases were followed up to the end of the
pregnancy, and 21 (23.6%) of them had adverse outcomes. The
prognoses of isolated
umbilical cord cyst cases were all good. Two
pregnancies (2/18) were terminated in the
umbilical cord cyst with ultrasound soft markers group. In the group of
umbilical cord cyst with
fetal malformation, 19
pregnancies (19/26, 73.1%) had adverse outcomes, including
pregnancy termination, intrauterine
fetal demise, and
perinatal death.
Conclusions:
The
prognosis of isolated
umbilical cord cysts is generally good. The
umbilical cord cyst complicated by soft ultrasound marker and
fetal malformation can have adverse outcomes, while conditions might be worse in those with
fetal malformation. When an
umbilical cord cyst is revealed, a systematical examination is recommended to identify whether it is combined with other ultrasound
abnormalities.