Prenatal diagnosis and perinatal outcomes of umbilical cord hemangioma: two case reports and a literature-based perspective.

Umbilical cord hemangioma is a rare benign vascular tumor associated with potentially serious perinatal complications; however, the prognostic significance of specific imaging findings and the optimal strategies for prenatal surveillance and perinatal management remain incompletely defined. We report two cases of umbilical cord hemangioma diagnosed prenatally by ultrasonography and confirmed by postnatal histopathological examination. In both cases, the lesion presented as fusiform enlargement of the umbilical cord with mixed echogenicity, comprising hyperechoic nodular components and cystic changes. Advanced Doppler imaging demonstrated branching intralesional vascular channels, facilitating recognition of the lesion. Despite apparently reassuring conventional Doppler indices in one case, intrauterine fetal demise occurred at 36 weeks, most likely related to progressive vascular compression. In the second case, right umbilical artery thrombosis and progressive cystic enlargement were detected on serial examinations, and a live infant was delivered at 33 weeks. These findings suggest that a recognizable sonographic pattern, together with detailed vascular assessment, may aid in the prenatal identification of umbilical cord hemangioma. Importantly, our observations suggest that conventional Doppler parameters alone may not fully reflect evolving hemodynamic compromise in some cases. Close follow-up with attention to structural evolution and signs of vascular compromise may assist clinical management, although validated prognostic markers are cuCrrently lacking.