#41019
Stephen Bird
Keymaster

Hi Katrina,

Thanks for sharing this lovely case,

With cord cysts:

Prevalence: 1 in 100 pregnancies.

True cysts are derived from the embryological remnants of either the allantois or the omphalomesenteric duct and are typically located towards the fetal insertion of the cord.

Pseudocysts are more common than true cysts and are located anywhere along the cord. They have no epithelial lining and represent localized edema and liquefaction of Wharton’s jelly.

Single cysts are usually transient with no adverse effect and require no special management. Some articles suggest that even a solitary cyst may be associated with other abnormalities and karyotype should be offered.

Multiple cysts are associated with increased risk of miscarriage, trisomies 18 and 13, omphalocele, VACTREL association and fetal growth restriction. Karyotyping is suggested.

From my perspective as a sonographer scanning in a general radiology practice I would treat it as an anomaly worth referring for tertiary opinion. I would complete the scan searching in detail for other abnormalities / anomalies and then ask our tertiaty obstetric facility to review the case and advise the patient.

I take this perspective for many fetal anomalies. For example if I find a right sided aortic arch or a persistent left sided SVC these are not in themselves significant abnormalities, however they are variations from the normal so I fell they should be assessed by the tertiary referral specialists to ascertain if I am missing something more significant and to council the patient.

The tertiary hospital in Adelaide is happy to provide such a service and it helps me to self-audit my performance when they advise me I found everything or missed something else etc. They also provide feedback to me and the patient about how management may be changed.
I have attached a nice example of a cord cyst from my collection.

Steve.

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