Four-vessel umbilical cord with three arteries and one vein: a case report and literature review

ABSTRACT
Background. Four-vessel umbilical cord (FVUC) is a rare embryonic anomaly, characterized by the presence of an umbilical cord with 4 vessels, usually 2 arteries and 2 veins. In early embryonic life, at 4th week, three pairs of major veins (vitellins veins drain the yolk sac, cardinal veins drain foetal body, and umbilical veins from the placenta) are connected to the primitive foetal heart at the sinus venosus. A multivessel cord has been associated with congenital anomalies, especially cardiac abnormalities, but also intrauterine growth restriction (IUGR). A more uncommon anomaly is when a FVUC is made by three arteries and one vein, with only two cases described in the literatures.
Case presentation. Here we report a rare case of FVUC with three arteries and one vein.
Conclusions. FVUC is an uncommon condition associated with major malformations and high risk of IUGR. Cases with three arteries and one vein seem to be associated with better outcomes