What is the normal structure of the Umbilical Cord?

Explanation

Core Concept: The normal umbilical cord contains three blood vessels: one large umbilical vein and two smaller umbilical arteries. The single vein carries oxygenated, nutrient-rich blood from the placenta to the fetus, while the two arteries carry deoxygenated, waste-rich blood from the fetus back to the placenta.

Clinical Presentation:

• Normal cord: Three vessels, covered by Wharton's jelly.
• Single Umbilical Artery (SUA): Associated with an increased risk of congenital anomalies (cardiac, renal, chromosomal).

Diagnosis:

• First-line diagnostic plan: Visual inspection and counting of the cord vessels immediately after delivery.
• Gold standard test: Prenatal or postnatal ultrasound and comprehensive fetal anomaly scan if a single umbilical artery is identified.

Management:

• Acute management: Proper clamping and cutting of the cord after birth. Routine newborn care.
• Gold standard long-term/definitive management: If a two-vessel cord (SUA) is found, conduct a thorough pediatric evaluation, including renal and cardiac ultrasounds, to rule out associated congenital defects.