Cystic hygroma with single umbilical artery

Albana Cerekja, MD, PhD*, Carlo Figliolini, MD, PhD**, Juan Piazze MD, PhD***

*   Ultrasound Division, ASL Roma B, Rome, Italy.
**  Reparto di ostetricia e ginecologia, Ospedale Fatebenefratelli San Pietro Rome, Italy.
*** Ultrasound Division, Ceprano Hospital, Ceprano, Italy.

Case report

This is a case of the first pregnancy of a 36-years-old patient. She conceived spontaneously after 6 years of infertility. Personal and family history were unremarkable.

First ultrasound examination was performed at 7 weeks of gestation. The crown-rump length corresponded with the duration of amenorrhea. At the ultrasound examination at 12 weeks, we revealed a hygroma colli and generalized subcutaneous edema associated with a single umbilical artery. No other anomalies seemed to be present. Cardiac examination did not show any anomalies. The crown-rump length was normal.

Patient underwent a chorionic villous sampling the day after the ultrasound examination. Both the preliminary and the definitive result showed a normal female karyotype.

The subsequent scan was performed 10 days later. We noticed a slight regression of the hygroma but further dilation of the jugular sacs was evidenced.

The couple opted for pregnancy termination. The karyotype of the aborted fetus showed a normal female karyotype, 46 XX. The autopsy was not performed.

Images 1,2: Image 1 shows a coronal view of the fetus, note cystic hygroma, jugular sacs along the sides of the neck, are dilated. Image 2 shows a sagittal view with apparent hygroma colli and subcutaneus edema.

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Images 3,4: Images shows dilated jugular sacs.

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Images 5,6: Transverse view showing the cystic hygroma and generalized subcutaneus edema.

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Images 7,8: Images taken at 14 weeks show slight regression of the cystic hygroma.

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Images 9,10: Image 9 shows the fetal heart. Image 10 shows a single umbilical artery.

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Videos 1,2: Video 1 shows the cystic hygroma and generalized edema. Video 2 shows the fetal heart, with no apparent anomaly.

Video 3: Video showing the single umbilical artery.

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