Prevalence:

• 1 in 100 pregnancies.

Ultrasound diagnosis:

• 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.

Associated abnormalities:

• Single cysts are usually transient with no adverse effect.
• Multiple cysts are associated with increased risk of miscarriage, trisomies 18 and 13, omphalocele, VACTREL association and fetal growth restriction.

Investigations:

• Detailed ultrasound examination.
• Fetal karyotyping for non-isolated cases.

Prognosis:

• Isolated cases: normal prognosis.

Recurrence risk:

• Isolated cases: no increased risk of recurrence.
• Part of trisomies: 1%.