Papoff Paola, D'Agostino Benedetto, Bitti Antonella, Pennetta Valentina, Avarino Valeria, Caresta Elena
Maternal and Child Health Department and Urological Sciences, Pediatric Intensive Care Unit, Sapienza University of Rome, Rome, Italy.
PICU, Umberto I Policlinico of Rome, Sapienza University of Rome, Viale Regina Elena, Rome, 324 00161, Italy.
Matern Health Neonatol Perinatol. 2025 May 1;11(1):11. doi: 10.1186/s40748-025-00209-8.
Umbilical vein catheterization is relatively straightforward procedure because the vein is easily recognized as a single, large, thin-walled vessel. However, anomalies of the umbilical vessels, such as the multivessel cord, which embeds more than two arteries or more than one vein, can result in catheter misplacement.
We present a unique case of a supernumerary patent umbilical artery in an asphyxiated term neonate, which resulted in the misplacement of the umbilical venous catheter in one of the three arteries. The diagnosis of artery cannulation was made through a comprehensive analysis of the patient's blood gases, the use of a pressure transducer to confirm the presence of a pulsatile arterial signal, and the interpretation of a chest X-ray. Subsequently, the catheter was removed without complication. A more detailed examination of the umbilical cord revealed the presence of three arteries and a vein, which was then successfully cannulated.
This case reinforces the notion that the umbilical cord may include more than three vessels, and that umbilical vein cannulation requires prior meticulous observation of the number of vessels to prevent misplacement of the catheter.
脐静脉插管是一种相对简单的操作，因为脐静脉很容易被识别为单一的、粗大的薄壁血管。然而，脐血管异常，如多血管脐带（包含两条以上动脉或一条以上静脉），可能导致导管误置。
我们报告了一例足月儿窒息合并额外存在一条永存脐动脉的独特病例，该病例导致脐静脉导管误置于三条动脉之一。通过综合分析患者的血气、使用压力传感器确认搏动性动脉信号的存在以及解读胸部X线片，确诊为动脉插管。随后，导管被顺利拔除，未出现并发症。对脐带进行更详细的检查发现有三条动脉和一条静脉，随后成功进行了插管。
该病例强化了这样一种观念，即脐带可能包含三条以上血管，并且脐静脉插管需要事先仔细观察血管数量，以防止导管误置。
