Patent urachus or bladder exstrophy occulta? A case of prenatally disappeared umbilical cord cyst

Chien, Chih-Wei; Chen, Kuan‐Ju; Lai, Jenn‐Haung; Chao, An‐Shine

doi:10.1016/j.eucr.2021.101772

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…In all cases of UAA, the cystic appearance of UAA during ultrasonography routine checkups can potentially lead to a misdiagnosis of a non-lethal umbilical cord pseudocyst, patent urachus or omphalocele ( 29 , 33 – 35 ). Current guidelines for management of umbilical cord cysts in the second and third trimester imply to perform fetal karyotype testing in order to rule out aneuploidy, due to the frequent association of umbilical cord cysts and chromosomal anomalies such as trisomy 13 or 18 ( 29 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Umbilical vessel aneurysm thrombosis and factor V Leiden mutation leading to fetal demise

Oualiken

Martz²,

Idrissi³

et al. 2023

Front. Med.

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Complicated pregnancies are nowadays a major public health concern, with possible lethality or sequelae both for the mother and the fetus. Blood coagulation disorders (including antiphospholipid syndrome, factor V Leiden mutation and antithrombin deficiency) and hypertensive gestational disorders are very well-known contributors of complicated pregnancies with poor fetal outcome, such as intrauterine growth retardation (IUGR) and fetal demise. Less commonly, vascular malformations of the placenta can also potentially lead to serious complications such as IUGR and fetal death. These malformations include hypercoiled umbilical cord, umbilical cord knot, umbilical cord varix, umbilical cord arterial or venous aneurysm, and velamentous insertion of the umbilical cord potentially leading to Benckiser's hemorrhage. Here, we report the case of a 29-year-old Gravida 2 Para 0 mother with previous history of stillbirth and smoking, admitted to the obstetrics department for the absence of fetal movement at 38 weeks of amenorrhea (WA). First-trimester and second-trimester routine ultrasounds were otherwise normal. Ultrasound performed at 38 WA revealed a 83 × 66 × 54 mm cystic heterogenous mass at the umbilical cord insertion. After delivery, fetal and placental pathology as well as maternal blood testing were performed. Fetal pathology was otherwise normal, except for diffuse congestion and meconial overload suggesting acute fetal distress. Fetal karyotype was normal (46 XX). Placental pathology revealed an umbilical artery aneurysm (UAA) at the base of the insertion of the umbilical cord, lined with a CD34+ CD31+ endothelium. After dissection, the aneurysm was filled with hemorrhagic debris, indicating aneurysm thrombosis. Histopathology revealed associated maternal vascular malperfusion (MVM) and increased peri-villous fibrin (IPF). Maternal blood tests revealed heterozygous factor V Leiden mutation, without other associated auto-immune conditions (such as antiphospholipid syndrome). Umbilical artery aneurysms remain extremely rare findings in the placenta, with <20 reported cases. Umbilical artery aneurysms have tendency to be located at the base of the insertion of the placenta, and lead to fetal demise in more than 60% of cases, mainly due to aneurysmal thrombosis, hematoma, possible vascular compression and/or rupture. Umbilical vessel aneurysms can be associated with trisomy 18 or 13. In our case, the association of factor V Leiden mutation, a hypercoagulable state, with UAA could explain massive thrombosis of the aneurysmal lumen and sudden fetal demise. Further consideration of current guidelines for surveillance and management of UAA would allow appropriate planned delivery in maternal care settings.

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Section: Discussionmentioning

confidence: 99%

Case report: Umbilical vessel aneurysm thrombosis and factor V Leiden mutation leading to fetal demise

Oualiken

Martz²,

Idrissi³

et al. 2023

Front. Med.

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“…Therefore, the size of cysts and the blood flow of the UC should be evaluated regularly by ultrasound when the UCC is diagnosed. In addition, there are a number of reported cases of UCCs that are diagnosed prenatally and, as the pregnancy progresses, the cyst ruptures spontaneously and turns to be patent urachus 40–44 . The urachus is a remnant of the allantois, which extends from the umbilicus to the bladder.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, there are a number of reported cases of UCCs that are diagnosed prenatally and, as the pregnancy progresses, the cyst ruptures spontaneously and turns to be patent urachus. [40][41][42][43][44] The urachus is a remnant of the allantois, which extends from the umbilicus to the bladder. It will result in four urachal anomalies: cyst, sinus, diverticulum, and patent urachus, due to varying degrees of luminalization.…”

Section: Complications Of Uccmentioning

confidence: 99%

Umbilical cord cysts: Classification, diagnosis, prognosis, and pregnancy recommendations

Chen,

Jia,

Yang

et al. 2023

Intl J Gynecology & Obste

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Umbilical cord cysts (UCCs)—cysts located in the umbilical cord that are derived from an abnormal embryonic development process—are typically an incidental discovery during prenatal ultrasound. It can be described as either a pseudocyst or a true UCC, which results from focal edema or degeneration of Wharton jelly or the remnants of embryonic development, respectively. Due to the relative rarity of the UCC, the clinical guidance of UCCs is not yet available. Herein, the aim of this paper is to discuss the classification, diagnosis, prognosis, and clinical management of UCCs through a literature review, in order to improve the understanding of UCCs among clinical obstetricians and pediatricians.

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“…Kejadian infeksi tali pusat dapat dicegah dalam berbagai kasus (Maharani & Yudianti, 2016). Dalam pencegahan dan mengurangi angka kematian bayi penting untuk mengidentifikasi bagaimana melakukan teknik perawatan tali pusat terbaik (Chien et al, 2021). Selain itu, memberikan alternatif bagi ibu untuk menghindari penggunaan bahan yang berbahaya dalam melakukan perawatan tali pusat pada bayinya (Moskow et al, 2019).…”

Section: World Health Organization (Who)unclassified

Teknik Perawatan Tali Pusat terhadap Pelepasan Tali Pusat

Din'ni

Meliati

2021

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The incidence of infection in newborns (BBL) in Indonesia is 24%-34%. Infection in BBL is the number 2 cause of neonatal death by 49%-60%. Neonatal mortality in developing countries is 50% due to umbilical cord infection, sepsis and neonatal tetanus. The purpose of this study was to analyze the effectiveness of umbilical cord care in newborns using dry open technique and sterile gauze against umbilical cord rupture. The type of research was pre-experimental post-test only design and the sample of this study was 30 newborns at the Puskesmas with purposive sampling technique. The study was conducted for 3 months. The results showed that the umbilical cord care technique with the dry open method made the umbilical cord detach faster than the sterile gauze method. The time for releasing the umbilical cord with the dry open method took 123.8 hours and the time for releasing the umbilical cord with sterile gauze took 170.8 hours. The results of the analysis showed the significance value of 0.004 and the Levin test result of 138%. Conclusion there is no more effective between sterile gauze and dry open umbilical cord treatment against umbilical cord detachment. Suggestions for midwives and health workers can socialize postpartum mothers in umbilical cord care for newborns using open techniques and sterile gauze.

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Patent urachus or bladder exstrophy occulta? A case of prenatally disappeared umbilical cord cyst

Cited by 4 publications

References 5 publications

Case report: Umbilical vessel aneurysm thrombosis and factor V Leiden mutation leading to fetal demise

Case report: Umbilical vessel aneurysm thrombosis and factor V Leiden mutation leading to fetal demise

Umbilical cord cysts: Classification, diagnosis, prognosis, and pregnancy recommendations

Teknik Perawatan Tali Pusat terhadap Pelepasan Tali Pusat

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