††slugcomment: To be submitted to the Astrophysical Journal Letter Persistent umbilical cord cysts and pregnancy outcome: a ten-year retrospective study in a tertiary referral centre

Objective: Umbilical cord cysts represent the second most common anomalies of the umbilical cord structure, although they seldom persist in the second and third trimesters. Method: A retrospective review was conducted on pregnant women who delivered at our centre in the past decade and were prenatally diagnosed with umbilical cord cysts. Information on pathological results, prenatal sonographic findings, maternal demographics, and perinatal outcomes was extracted from the medical records. Follow-up assessments for surviving children involved phone interviews. Results: 24 hospitalized patients were identified with umbilical cord cysts on postnatal examination. Two of these cases involved combined fetal chromosome abnormalities or severe fetal structural anomalies. Intrauterine death occurred in two cases, and the remaining 22 fetuses had a preterm birth rate of 31.8%, with two instances of fetal distress and three cases of combined small-for-gestational-age infants. Caesarean section was the predominant mode of delivery. Conclusion: This study represents the largest investigations into persistent umbilical cord cysts. Cysts persisting into the second and third trimesters may cause local complications, increasing the risk of fetal distress and demise. Currently, there are no validated indicators to predict adverse intrauterine events in umbilical cord cysts. Physicians, in cases of particular concern, may discuss the need for and feasibility of intrauterine therapy with patients.