Wharton's jelly umbilical cord cyst

Umbilical cord cysts occur in 3% of pregnancies. They are classified as true cysts and pseudocysts. Most cysts diagnosed during the first trimester of pregnancy have no pathological significance, but 13% may have structural alterations, and if they persist throughout pregnancy increases the percentage. These abnormalities are more frequent if the cyst is close to the fetal or placental insertion, are eccentric and multiple. When they are diagnosed in the second and third quarter, they may associate up to 50% structural and chromosomal abnormalities.

The urachus is a structure that connects the bladder to the anterior abdominal wall, at the navel. During the early development is a permeable tube but subsequently obliterated, leaving a solid cord tissue. It persists in 1/150 000 newborns. According to the level of the persistent urachus it is classified into patent urachus, cyst, sinus or diverticulum.

The diagnosis is made by ultrasound. Fistulography can be performed before surgery. The abdominal CT scan or MR may be needed to confirm the diagnosis. Treatment should be surgical and prompt, to avoid the risk of local infection, or urinary infection, sepsis and malignant degeneration.