Horváth-Varga Éva, Hódi Eszter, Pásztor Gyula, Katona Márta, Orvos Hajnalka, Gyurkovits Zita
Department of Obstetrics and Gynecology, Albert Szent-Györgyi Health Center, University of Szeged, 6725 Szeged, Hungary.
Department of Radiology, Albert Szent-Györgyi Health Center, University of Szeged, 6725 Szeged, Hungary.
Children (Basel). 2025 Mar 26;12(4):418. doi: 10.3390/children12040418.
: The umbilical cord normally contains two arteries and one vein. The presence of supernumerary-four or five-umbilical cord vessels is a rare phenomenon, with few cases reported in the literature. The majority of cases are detected postnatally. However, given their potential association with developmental abnormalities, primarily severe cardiac anomalies and genetic disorders, the prenatal diagnosis of supernumerary umbilical cord vessels may have clinical relevance. : A review of the clinical phenomenon of the four-vessel umbilical cord and its complications was conducted using case studies and literature reviews in PubMed from 1977 to the present and in Google Scholar from 1966 to the present. : Among the 24 reported cases, 7 cases were associated with malformations, 8 cases were detected antenatally, and 16 cases postpartum. Among the eight antenatally diagnosed cases, only one had a congenital malformation, hydrops fetalis. Among the postnatally diagnosed cases, six had congenital abnormalities: three were cardiovascular, two were associated with hydrops, urinary, gastrointestinal, and skeletal disorders, hypoplastic corpus callosum, and dysmorphic facial features. Four-vessel umbilical cords are more frequent than previously thought, as they can be easily overlooked during the mandatory ultrasound examination. A review of the literature revealed a correlation between supernumerary umbilical cord vessels and major congenital malformations, underscoring the significance of prenatal diagnosis; however, the four-vessel cord may not always be indicative of a serious condition.
脐带通常包含两条动脉和一条静脉。出现额外的——四条或五条——脐带血管是一种罕见现象，文献中报道的病例很少。大多数病例是在出生后才被发现。然而，鉴于它们可能与发育异常相关，主要是严重心脏异常和遗传疾病，产前诊断额外的脐带血管可能具有临床意义。
通过对1977年至今PubMed以及1966年至今谷歌学术上的病例研究和文献综述，对四血管脐带的临床现象及其并发症进行了回顾。
在报告的24例病例中，7例与畸形相关，8例在产前被发现，16例在产后被发现。在产前诊断的8例病例中，只有1例有先天性畸形，即胎儿水肿。在产后诊断的病例中，6例有先天性异常：3例为心血管异常，2例与水肿、泌尿、胃肠和骨骼疾病、胼胝体发育不全以及面部畸形有关。四血管脐带比之前认为的更为常见，因为在强制性超声检查期间它们很容易被忽视。文献综述显示额外的脐带血管与主要先天性畸形之间存在关联，凸显了产前诊断的重要性；然而，四血管脐带不一定总是意味着病情严重。
