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American Academy of Pediatrics
Visual Diagnosis

A Large Tortuous Umbilical Cord with Superficial Abdominal Wall Varicose Veins in a Newborn

Sara Soares, Ana Cristina Freitas, Cidade Rodrigues, Luísa Lopes, Carmen Carvalho and Sandra Pereira
NeoReviews November 2020, 21 (11) e774-e777; DOI: https://doi.org/10.1542/neo.21-11-e774
Sara Soares
*Neonatology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Ana Cristina Freitas
*Neonatology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Cidade Rodrigues
†Pediatrics Surgery Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Luísa Lopes
*Neonatology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Carmen Carvalho
*Neonatology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Sandra Pereira
*Neonatology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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The Case

Term male newborn presented at birth with a varicose umbilical cord and a collateral abdominal circulation.

Prenatal, Birth, and Family Histories

  • Born to a 27-year-old gravida 2, para 2 woman

  • Nonconsanguinity in the family

  • Normal prenatal maternal laboratory screening and fetal survey

  • Benign prenatal course

  • Delivery at 39 weeks’ gestation via vaginal delivery

  • Apgar scores 9, 10, and 10 at 1, 5, and 10 minutes, respectively

  • Birthweight: 2,810 g (11th percentile); length: 47.5 cm (8th percentile); head circumference: 33.5 cm (15th percentile)

Presentation

After delivery, the infant’s umbilical cord appeared to be tortuous and twice the normal width; in addition, large centrifugal varicose veins were noted bulging under the adjacent skin and extending to the anterior abdominal wall (Figs 1–3). The infant appeared otherwise well but was transferred to the NICU for monitoring and further evaluation.

Figure 1.

Tortuous and twice the normal width umbilical cord and large centrifugal varicose veins extending to the anterior abdominal wall.

Figure 2.

Detailed frontal view.

Figure 3.

Lateral view of the abnormal umbilical cord.

Progression

Physical Examination (Newborn Day).

  • General: Active; normal color

  • Head and neck: Normocephalic; anterior fontanelle open and flat; neck veins not enlarged

  • Lungs: Regular respiratory rate, breath sounds bilaterally equal, no increased work of breathing

  • Cardiovascular: Normal S1 and S2, no murmur; femoral pulses present; capillary refill 2 seconds

  • Abdomen: Umbilical cord was tortuous and engorged to twice the normal width (no increase in vessel size during crying); centrifugal varicose veins were bulging under the …

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NeoReviews
Vol. 21, Issue 11
1 Nov 2020
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A Large Tortuous Umbilical Cord with Superficial Abdominal Wall Varicose Veins in a Newborn
Sara Soares, Ana Cristina Freitas, Cidade Rodrigues, Luísa Lopes, Carmen Carvalho, Sandra Pereira
NeoReviews Nov 2020, 21 (11) e774-e777; DOI: 10.1542/neo.21-11-e774

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A Large Tortuous Umbilical Cord with Superficial Abdominal Wall Varicose Veins in a Newborn
Sara Soares, Ana Cristina Freitas, Cidade Rodrigues, Luísa Lopes, Carmen Carvalho, Sandra Pereira
NeoReviews Nov 2020, 21 (11) e774-e777; DOI: 10.1542/neo.21-11-e774
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