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Expert Q&A

	By David L. Fay, M.D. Family Physician Associate Director, Waukesha Family Practice Residency Program

One of my twins was diagnosed with a two-vessel cord. There are no other problems with her. What other problems can be associated with this when everything else with her was perfect?

The umbilical cord normally contains three blood vessels: two arteries and one vein. The incidence of a two-vessel cord (or single umbilical artery) is approximately five to 10 in 1000 births; the frequency in twins is about 35 to 70 in 1000 births. About 15 to 30 percent of affected infants have associated abnormalities including cardiovascular (heart and blood vessel), renal (kidneys) and Trisomy-18 (a syndrome with severe abnormalities and mental retardation).

It is generally recommended to have echocardiography (ultrasound of the heart) and kidney ultrasound after birth to look for hidden abnormalities despite the fact that the majority of children are normal.

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