The significance of one umbilical artery.

Absence of one umbilical artery is a rare finding, usually associated with other severe congenital malformations. The earliest recorded case is attributed to Casp. Bauhin in 1621, although Noortwyck (1743) quotes Vesalius' description 'unam tantum arteriam in fune Fallopius vidit'. Otto (1830) collected 41 case reports from the literature, and Hyrtl (1870) described 14 cases of his own and found 16 more in the literature. Browne (1925) referred to one case with a single artery and numerous capillaries replacing the vein. Benirschke and Brown (1955) described 55 cases, and Richart and Benirschke (1958) described one further case with gonadal dysgenesis. Javert and Barton (1952) examined the umbilical cord of 297 aborted foetuses of four months' gestation and found one with a single artery. Of the 182 cases of sympodia collected by Ballantyne (1898), Kampmeier (1927) and Hendry and Kohler (1956), 95 had a single artery in the umbilical cord, and in the remainder the cord was not examined. Schatz (1900) found 11 cases among 46 acardiac monovular twins and three acardiac monovular triplets. There is therefore clearly a high incidence in acardiac foetuses and sympodia. In foetuses without acardia or sympodia the incidence appears to be relatively low, and only Javert and Barton (1952) provide data from which an assessment can be made. This paper describes 11 cases encountered among routine autopsies performed at the Birmingham Children's Hospital from March, 1958, to February, 1959, in autopsies on 159 stillbirths and 252 live born babies of 8 weeks of age or less. Severe malformations were found in nine (81%) and in 23% of the controls.