Four‐vessel umbilical cord

Avnet, H.; Shen, O.; Mazaki, Eyal; Daniel-Spiegel, Etty

doi:10.1002/uog.9045

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…18 Reviewing the literature describing the portal vein architecture in adults, PRUV is commonly referred to as right-sided Ligamnetum Teres, [19][20][21] and in some early descriptions as a left sided gallbladder. 22 In 2012 Shindoh et al 23 Concerning the unique case of two umbilical veins (Figures 5 and 6), similar cases were described previously 25,26 showing an identical pattern, including a three vessel umbilical cord in the placental end becoming a four vessel cord in the fetal end. The two umbilical veins enter the abdomen and communicate with the corresponding portal vein that later unite at the bifurcation of the MPV to form a closed vascular loop.…”

Section: Prenatal Diagnosis Of Pruv Typically Relies On Indirect Anatom-supporting

confidence: 60%

In‐utero evaluation of the fetal umbilical–portal venous system among fetuses with persistent right umbilical vein: Two‐and three‐dimensional ultrasonographic study

Massarwa,

Weissbach,

Hadi

et al. 2024

Prenatal Diagnosis

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ObjectiveThe aim of this study was to describe the anatomy of the portal system in fetuses with persistent right umbilical vein (PRUV).MethodsProspective observational study of fetuses diagnosed with PRUV. All patients underwent a comprehensive portal system anatomy scan supplemented by two‐dimensional (2D) and three‐dimensional (3D) color doppler modalities.Results29 fetuses with PRUV were studied. We perceived an identical anatomical pattern in 28 fetuses. The right umbilical vein drains to the portal sinus (future right portal vein, RPV), which has a configuration of a left portal vein (LPV) in the normal left portal system, with three emerging branches: inferior (RPVi), medial (RPVm) and superior (RPVs). The RPV then courses to the left, towards the stomach to the point of the bifurcation of the main portal vein (MPV) to become the left portal vein. The LPV has an RPV configuration in a normal portal system with anterior (LPVa) and posterior (RPVp) branches. This anatomical layout mimics a mirror image of the normal anatomy of left portal system.ConclusionPRUV has unique umbilical portal venous anatomy, which is a mirror image of the normal left portal system. It can be demonstrated prenatally and serve as an additional tool for prenatal diagnosis of PRUV.

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Section: Prenatal Diagnosis Of Pruv Typically Relies On Indirect Anatom-supporting

confidence: 60%

In‐utero evaluation of the fetal umbilical–portal venous system among fetuses with persistent right umbilical vein: Two‐and three‐dimensional ultrasonographic study

Massarwa,

Weissbach,

Hadi

et al. 2024

Prenatal Diagnosis

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“…Thus the normal umbilical cord consists of two UAs and one UV. While a persistent four-vessel umbilical cord rarely occurs [30], the most common cord variant, with an incidence of approx. 0.5 % in the second trimester [31], is a single UA (two vessels: one vein and only one artery; SUA = single umbilical artery).…”

Section: Number Of Vessels/single Umbilical Arterymentioning

confidence: 99%

Sonographic Assessment of the Umbilical Cord

Bosselmann

Mielke

2015

Geburtshilfe Frauenheilkd

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Introduction !The umbilical cord (UC) is the essential life-sustaining connection between fetus and placenta. It constitutes a stable connection to the fetomaternal interface, while allowing fetal mobility that is essential for fetal development in general and neuromotor development in particular. This combination of mechanical stability and flexibility is due to the architecture of the UC. There is however a range of umbilical cord complications that may be life threatening to the fetus, and these too can be explained to a large extent by the cordʼs structural characteristics. Examination of cord vessels using Doppler ultrasound enables investigators to deduce the state of the fetoplacental vascular bed, providing essential information on the condition of the fetus. Development and Architecture of the Umbilical Cord !In its embryonic stage the UC develops in the region of the body stalk to become the embryoʼs connection to the fetal portion of the placenta (fetal placenta). The amniotic cavity expands from dorsal to ventral while the chorionic cavity shrinks in volume. During cephalo-caudal and lateral folding the early UC arises as it is "enveloped" by the expanding amnion (l " Fig. 1) (see also textbooks of embryology, www.embryology.ch). In this early stage at around 7-8 weeks postmenstrual age the UC contains the body stalk with umbilical vessels as well as other structures that will later regress and disappear entirely: the allantoic diverticulum (an outpouching from the endoderm connected to the (future) urinary bladder, later the urachus), as well as the extra-embryonic coelom that at this early stage still forms a connection to the cho- Abstract !The umbilical cord (UC) is a vital connection between fetus and placenta. It constitutes a stable connection to the fetomaternal interface, while allowing the fetal mobility that is of great importance for fetal development in general and fetal neuromotor development in particular. This combination of mechanical stability and flexibility is due to the architecture of the UC. There is however a range of umbilical cord complications that may be life threatening to the fetus and these too can be explained to a large extent by the cordʼs structural characteristics. This review article discusses clinically relevant aspects of UC ultrasound. Zusammenfassung !Die Nabelschnur ist die lebenswichtige Verbindung zwischen Fetus und Plazenta. Sie bildet einerseits eine stabile Verbindung zur zentralen Einheit des fetomaternalen Stoffwechsels und ermöglicht dem Feten andererseits eine Beweglichkeit, die für die körperliche -insbesondere die neuromotorische -Entwicklung von großer Bedeutung ist. Diese Kombination aus mechanischer Stabilität und Flexibilität begründet sich in der Architektur der Nabelschnur. Es gibt jedoch eine Reihe an Nabelschnurkomplikationen, die den Feten z. T. lebensbedrohlich gefährden können. Auch diese lassen sich vor allem auf die strukturellen Eigenschaften der Nabelschnur zurückfüh-ren. Im Rahmen einer Übersichtsarbeit werden klinisch relevante Asp...

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“…Normally, the right umbilical vein becomes obliterated at 28-32 days of gestation, disappearing by the seventh week of gestation, and the single umbilical vein present at birth is derived from the primitive left umbilical vein. 9 The presence of two veins could be attributed to the persistence of both the normal left umbilical vein and the caudal part of the right umbilical vein (supernumerary were detected antenatally (Cases 4, 5,7,8,10,11,16), whereas in the other nine cases, it was found postpartum. Fetal age at the time of detection ranged from 21 to 35 gestational weeks.…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of four‐vessel umbilical cord with supernumerary vein varix: A case report and literature review

Lei

Xie

Jin

2017

J of Obstet and Gynaecol

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Four-vessel umbilical cord with two arteries and two veins, and fetal intra-abdominal umbilical vein varix are rare fetal vascular pathologies, associated with congenital anomalies and an adverse perinatal outcome, respectively. We report a case of a healthy male neonate born at a gestational age of 38 weeks, five days, after prenatal sonographic diagnosis of a four-vessel umbilical cord with a supernumerary vein varix. To the best of our knowledge, this is the first case with this combination.

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Four‐vessel umbilical cord

Cited by 8 publications

References 16 publications

In‐utero evaluation of the fetal umbilical–portal venous system among fetuses with persistent right umbilical vein: Two‐and three‐dimensional ultrasonographic study

In‐utero evaluation of the fetal umbilical–portal venous system among fetuses with persistent right umbilical vein: Two‐and three‐dimensional ultrasonographic study

Sonographic Assessment of the Umbilical Cord

Prenatal diagnosis of four‐vessel umbilical cord with supernumerary vein varix: A case report and literature review

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