Bilateral Cystic Hygroma with Gross Polyhydramnios and Increased Nuchal Thickness - A Rare Mid-Trimester Ultrasonographic Presentation

Tejasa Mishra, Patel Mit Alpeshkumar*, Samarpan Raheja, Patel Shail Alpeshkumar, Deepak Jadaun, Shubhi Vaishya

Received : December 17, 2025 | Published : January 10, 2026

Citation: Alpeshkumar PM, Mishra T, Raheja S, Alpeshkumar PS, Jadaun D, Vaishya S. Bilateral Cystic Hygroma with Gross Polyhydramnios and Increased Nuchal Thickness - A Rare Mid-Trimester Ultrasonographic Presentation. J Surg Pract Case Rep. 2026;1(1):1-5.

Abstract

Cystic hygromas, referred to as cysts filled with fluid that develop due to abnormalities in the lymphatic system, often appear in the occipito-cervical or anterolateral area. The presence of these variations is attributed to the jugular lymphatic obstruction sequence, it occurs when the normal connect within the jugular lymphatic sacs jugular veins and does not form by the 40th day of pregnancy. Cystic hygromas, often linked to chromosomal disorders, provide a difficult prognosis. The survival rate for patients identified by prenatal testing is around 2-6%. However, if hydrops interacts with cystic hygroma, the possibility of fatality exceeds 100%. The prevalence of cystic hygroma is around 1 case per (6000-16000) live births. The study highlights a particular instance of a 20-year-old woman who became pregnant for the first time without any medical intervention. She worked as a sewing worker and did not use folic acid before or throughout the first three months of her pregnancy. Ultrasonography conducted at 16 weeks and 4 days detected a viable foetus inside the uterus with cystic hygroma, polyhydramnios, and other abnormalities. Although they received counselling about amniocentesis, the parents chose to terminate the pregnancy for medical reasons. This provided information on foetal anomalies such as cystic hygroma, occipital encephalocele, and spina bifi da occulta. After the termination, karyotyping revealed Turner syndrome (45X).