Department of Obstetrics and Gynecology, Bikur Holim Hospital, Jerusalem, Israel.
Ultrasound Obstet Gynecol. 2010 Sep;36(3):296-301. doi: 10.1002/uog.7576.
This study was carried out to determine the prognosis, and the clinical approach, in fetuses with umbilical cord cysts, during the second and third trimesters of gestation, according to our experience and data in the current literature.
We identified 10 fetuses with umbilical cord cysts that were diagnosed during the second and third trimesters of pregnancy at three referral centers. All underwent detailed ultrasound evaluation at the time of diagnosis and during follow-up. Prenatal karyotype testing was offered to all women. A MEDLINE review of the literature published from 1980 to 2009 was carried out to identify previous studies and case reports of fetuses with umbilical cord cysts.
In our series of 10 cases, significant additional abnormalities were observed in two during a detailed sonogram. In one case, trisomy 18 was diagnosed, leading to pregnancy termination, and in the other case a neonate with heart defects and a normal karyotype was born. These results differ from those reported in the literature, in which the association between second- and third-trimester umbilical cord cysts and fetal anomalies ranged from 38 to 100%.
In our study, as in other publications, an association was found between the presence of second- and third-trimester umbilical cord cysts and fetal anomalies. The strong association between second- and third-trimester umbilical cord cysts and aneuploidy in the literature seems to be biased, mainly because of the tendency to report abnormal cases. When these findings are accompanied by additional sonographic abnormalities, the association with aneuploidy is clear and should be an indication for fetal karyotype testing.
本研究旨在根据我们的经验和当前文献数据，确定妊娠中、晚期脐带囊肿胎儿的预后和临床处理方法。
我们在三个转诊中心共发现 10 例妊娠中、晚期诊断的脐带囊肿胎儿。所有病例在诊断时和随访期间均进行了详细的超声评估。所有孕妇均接受了产前染色体核型检测。对 1980 年至 2009 年发表的文献进行了 MEDLINE 综述，以确定先前有关脐带囊肿胎儿的研究和病例报告。
在我们的 10 例病例系列中，在详细的超声检查中有 2 例发现了明显的其他异常。其中 1 例诊断为 18 三体，导致妊娠终止，另 1 例新生儿有心脏缺陷和正常染色体核型。这些结果与文献报道不同，文献中报告的妊娠中、晚期脐带囊肿与胎儿畸形之间的相关性范围为 38%至 100%。
在我们的研究中，与其他出版物一样，发现了妊娠中、晚期脐带囊肿与胎儿畸形之间存在关联。文献中报道的妊娠中、晚期脐带囊肿与非整倍体之间的强相关性似乎存在偏倚，主要是因为倾向于报告异常病例。当这些发现伴有其他超声异常时，与非整倍体的相关性就很明确，应该进行胎儿染色体核型检测。
