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Umbilical cord cysts are rare anomalies, being associated in the first trimester most often with chromosomal defects or structural anomalies, while in the second and third trimesters, they are associated with urachal abnormalities. Umbilical cord cysts remain a pathology that could endanger the fetus by a rapid growth that could cause umbilical cord compression followed by fetal distress, torsion or thrombosis, with unfavorable consequences. We present the case of a pregnant patient diagnosed in the second trimester with umbilical cord cyst localized at the placental site of the umbilical cord, with a low-risk noninvasive prenatal test performed in the first trimester, with no other structural anomalies, who delivered a healthy baby at term. The intraoperative findings included the presence of an abnormally adherent placenta, respectively placenta accreta, in a patient with no surgical or obstetrical risk factors. The pathology report revealed an umbilical cord hematoma. The aim of this article is to debate whether an umbilical cord hematoma could be a marker for placental abnormalities. [ABSTRACT FROM AUTHOR]

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First-trimester screening is focused on both markers of aneuploidies and structural abnormalities detection. In the past ten years, clinicians have been increasingly interested in using Doppler ultrasound in the first trimester of pregnancy. Doppler examination can help estimate the risk of aneuploidy and early diagnose severe fetal malformations. The purpose of this article is to highlight the importance of color Doppler ultrasound examination of the fetus in the first trimester. Color Doppler examination also has a great significance in studying maternal-fetal circulation. According to the ISUOG guidelines, several vascular territories should be covered: uterine arteries, umbilical artery, and ductus venosus. The nowadays first trimester Doppler examination not only identifies specific ultrasonographic markers for aneuploidy but also aids in the identification and analysis of many anatomical structures. [ABSTRACT FROM AUTHOR]

Transvaginal ultrasound and serum concentration of human chorionic gonadotropin are the main methods of prognostic evaluation of early pregnancies. Although these pregnancy investigation methods have proven their benefits, the interpretation is fundamental for a correct diagnosis, in order to avoid interventions that may affect pregnancies that would normally have had a physiologic course, as well as to apply an appropriate management in the case of nonviable pregnancies. Recent studies have shown the need to adopt rigorous criteria that minimize false positive results and thus decrease the frequency of diagnostic errors. Over time, a series of ultrasound features have been described which have proven effective in predicting nonviable pregnancies in the first trimester (cranio-caudal length in relation to the presence or absence of cardiac activity, yolk sac diameter, gestational sac diameter in relation to presence or absence of embryo with cardiac activity, embryonic heart rate, subchorionic hematoma etc.). In the context of the new prospects for the development of artificial intelligence softwares, the present work focuses on the description of the precise ultrasonographic aspects aboded by the latest studies that propose certain cut-off values dependent on the gestational age of the ultrasound parameters in the first trimester, increasing the sensitivity and the specificity of ultrasound in the diagnosis of nonviable early pregnancies, thus aiming to improve the reproductive prognosis of couples with recurrent abortions. [ABSTRACT FROM AUTHOR]

Intrauterine growth restriction or fetal growth restriction represents a fetal incapacity of achieving its entire growth potential in intrauterine life, as a result of maternal, fetal and/or placental causes, from hypertension, autoimmune diseases, drug consumption, hereditary thrombophilia to genetic syndromes, intrauterine infections, umbilical cord anomalies or placental insufficiency. The ultrasonographic evaluation of the fetus with intrauterine growth restriction identifies an estimated fetal weight or a fetal abdominal circumference below the 10 th percentile for gestational age; a severe fetal growth restriction is defined as an estimated fetal weight below the 3rd percentile. The Delphi consensus managed to classify fetal growth restriction as early, being diagnosed under 32 weeks of gestation, respectively late, after 32 weeks of gestation. Up to 10% of pregnancies are complicated by fetal growth restriction, which are then considered high-risk pregnancies for the morbidity and mortality risk carried for the fetus, requiring an accurate diagnosis of the cause, intensifying the fetal monitoring and timing the birth, in order to deliver the fetus in safe conditions. This paper proposes an algorithm for an initial evaluation of fetal growth restriction, with the aim of simplifying the medical approach when encountering a fetus with intrauterine growth restriction, in order to improve morbidity and mortality rates among pregnancies complicated by fetal growth restriction. [ABSTRACT FROM AUTHOR]

Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies' guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies. [ABSTRACT FROM AUTHOR]