Rarely Encountered Umbilical Cord Pathologies (Literature Review)

Аннотация

This review systematizes current knowledge about umbilical cord abnormalities (UCAs) — a heterogeneous group of anomalies including length abnormalities, number of vessels, attachments, nodes, cysts, and vascular malformations. Based on the analysis of scientific literature (2000–2024), the epidemiological data are presented: UCAs occur in 15–35% of pregnancies, with single umbilical artery (SUA) — in 0.5–5%, velmen insertion — up to 50% in monochorionic twins, and true nodes — in 0.3–1.2%. The review details complications: fetal growth restriction (FGR), chronic and acute hypoxia, antenatal death, risks during childbirth (vascular rupture in vasa praevia, asphyxia). Particular attention is paid to early diagnostic methods: ultrasound with Doppler (blood flow assessment, EAP), color Doppler mapping (Velmen attachment), 3D/4D ultrasound in STIC mode (nodes, spatial anomalies), CTG monitoring. Differentiated management tactics are substantiated: from dynamic observation at low risk to planned cesarean section for vasa praevia or IUGR. It is emphasized that timely diagnostics and an individualized approach reduce perinatal mortality and improve outcomes. Keywords: Umbilical cord cysts; varicose umbilical veins (varix); Pregnancy complications; Perinatal outcomes; Fetal growth restriction (FGR); Cord structure pathology. vein varix", "fetal intra-abdominal umbilical vein varix", Introduction: In addition to relatively common "umbilical cord cyst", "rare umbilical cord anomalies (entanglement, EAP), there are rare abnormalities", "prenatal diagnosis", "pregnancy umbilical cord pathologies that pose significant outcome", "fetal complications", "ICD-10", "ICD-11". diagnostic and clinical challenges due to their low Original studies (prospective and retrospective cohort incidence, insufficient study, and potentially studies, case series), systematic reviews, meta- catastrophic consequences for the fetus. These include analyses, and clinical guidelines were included. umbilical cord hypoplasia, varicose umbilical veins Publications in languages other than English and (varix), and true umbilical cord cysts. Their prevalence Russian, without an abstract, and articles with a low does not exceed 1-3%, which complicates the level of evidence (reports of single cases without accumulation of evidence [1, 2]. literature analysis, expert opinions without data) were The objective of the review is to systematize data on excluded. epidemiology, classification (ICD-10/ICD-11),