Cord Hemangioma Complicated by Umbilical Vein Rupture; What We Missed on Color Doppler

Umbilical cord hemangiomas are rare tumors of the umbilical cord. Doppler ultrasound has been shown to be useful in the diagnosis of cord hemangioma and evaluation of arterial blood flow through the mass. In this study, we present a 28-year-old pregnant woman with an umbilical cord mass with solid and cystic components. She was followed with weekly umbilical artery (UA) Doppler ultrasound, but the fact that the umbilical vein (UV) ran in the wall of the mass was not noted prospectively. At the time of placental delivery, the cystic component of the mass ruptured tearing the UV causing significant bleeding. The case illustrates the importance of using Doppler ultrasound to both look for UA compromise and to map the UV location through the entirety of the cord.