Accidental catheterization of internal iliac artery branches: a serious complication of umbilical artery catheterization.

Umbilical artery catheters can accidentally enter branches of the internal iliac artery during attempted placement in the aorta. The three branches likely to be catheterized are the superior gluteal, inferior gluteal, and internal pudendal arteries. If these misplacements are not recognized and promptly corrected, arterial obstruction may lead to ischemia and infarction of the iliac bone, gluteal muscles, sciatic nerve, perineum, and overlying skin. We present three patients who suffered long-term consequences of umbilical artery catheter misplacements and discuss the radiographic verification of catheter placement that is essential before infusing medications.