Q. Should the pregnancy be terminated when there is cystic hygroma in ninth-week scan?

Answered by
Dr. Reetika Joshi
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Oct 12, 2021

Hi doctor,

Today we have completed the first ultrasound of our baby, who is nine weeks and five days gestation. Our doctor found out the baby is having a 3.5 mm cystic hygroma by interpreting the ultrasound image and advised us to visit the high-risk pregnancy doctor. We are worried much now. Could you please look at the ultrasound image and confirm where the cyst is located exactly and what the complications are associated with it. My wife and I are healthy, and in our families, nobody has any complications. Will the cyst go away on its own? Is 3.5 mm too large? Do we need to consider terminating the pregnancy? This is our second baby. The first baby is 18 months old and delivered via c-section. Kindly give your opinion.



Welcome to

I understand your concern and will surely help you. Firstly do not panic, please. The hygroma are observed in certain pregnant females during the first trimester. The cysts sometimes go away, and sometimes they tend to increase. 3.5 mm is relatively smaller, but the problem is that it may increase as the pregnancy progress, and that is generally complex. I would also recommend that you visit your treating gynecologist and ask her if the team at the hospital can manage the pregnancy. It is good that your first child is healthy, so do not worry, things will be fine.

Please share your other ultrasound also if you have one.

Do not worry. I am always there for you. Please feel free to ask any questions or to share any additional information.

Hello doctor,

Thank you.

My doctor office referred us to a high-risk pregnancy doctor. We are waiting for the call to schedule an appointment. We do not have any other ultrasound pictures. Could you please look at the picture shared and confirm to us where exactly is the cyst is present. What are the list of tests we need to take to figure out everything is normal related to genetic disorders? Kindly give your opinion.



Welcome back to

Cystic hygroma is present in the neck resulting from blockage of the lymphatic system (attachments remove to protect the patient's identity). It may be associated with chromosomal disorders like Turner's or down syndrome or sometimes heart diseases. But first, we have to be sure about the diagnosis.

Visit a fetal medicine specialist. A repeat scan can be done to confirm the findings. To rule out genetic causes, a double marker test followed by invasive testing like chorionic villus sampling can be done.

Even if genetic testing comes out normal, a four-weekly scan is advised till 38 weeks to see the growth of the cyst. Delivery is to be conducted at a well-equipped center with Pediatric surgeons and NICU (neonatal intensive care unit) facilities.

In some cases, like in a very early scan with the underdeveloped fetus, this cyst can be seen, which subsequently disappears. But we should take this cyst as benign only after ruling out other causes.

I hope this was helpful. Take Care.

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