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Medial funiculi furcata: a rare umbilical cord alteration

02 January 2025
Volume 33 · Issue 1

Abstract

The umbilical cord is important for fetal life, newborn prognosis and fetal programming of adult disease. It is important to understand its anatomical features and how they relate to perinatal outcomes. Literature has described anatomical abnormalities in the umbilical cord in relation to the number of vessels, coiling direction, number and depth of coils, insertion, knots, length, diameter, entanglement and constrictions. Each feature represents a potential risk for fetal and neonatal prognosis. This article presents two case studies with unusual anatomical abnormalities of the umbilical cord, the first in a 34-week newborn and the other in a 14-week malformed fetus, both with a partial medial membranous separation of the umbilical cord vascular structures. The unusual macroscopic anatomical abnormalities in these cases were classed as medial funiculi furcata.

The umbilical cord is the conduit between the placenta and the fetus, transporting oxygen and nutrients while allowing fetal mobility (Sherer et al, 2021). Among its anatomical alterations, those associated with length, diameter, insertion, number of vessels, coiling and entanglements are widely recognised as causes of unfavorable outcomes (Olaya-C et al, 2018). This case study describes two cases of an uncommon umbilical cord abnormality, one fetal and one neonatal, for which very few descriptions are found. The case studies were carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) and all procedures were approved by the Ethics Committee of the Pontificia Universidad Javeriana and the Hospital Universitario San Ignacio (MF-CIE-0533-24).

The first case involved a 33-year-old woman (gravida 4, para 2, miscarriage 1) at 34 weeks' gestation with a medical history of chronic hypertension, treated with nifedipine, alpha methyldopa and metoprolol. She also received acetylsalicylic acid and calcium supplementation as prophylaxis.

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