II. Physiology
- Umbilical vessels composed of 2 arteries and 1 vein
- Umbilicus separates within 2-3 weeks of delivery
- Dries and separates by 8 days in most infants
- Usually separation site heals by 15 days
III. Management: Routine care of Umbilicus
- Initial care: Clean cord and surrounding skin
- Sterile water or
- Mild cleanser with neutral pH (5.5 to 7.0)
- Ongoing cord care: Keep cord stump clean and dry
- Clean cord area with sterile water
- Keep cord area clean and dry
- Clean cord area when soiled with urine or stool
- Cleaning cord area with water alone is preferred
- Results in fastest cord separation
- No increased risk of Bacterial Infection
- Other cleaning or drying agents are not beneficial
- Background
- These agents do not shorten cord separation time
- These agents do not decrease risk of infection
- Agents to avoid
- Alcohol and other topical drying agents
- Topical Antibiotics (may prolong cord separation)
- Topical Antiseptics (may prolong cord separation)
- Background
- Clean cord area with sterile water
- References
IV. Findings: Abnormalities of the Umbilical Cord
- Umbilical Granuloma
- Urachal Anomaly
- Omphalitis (umbilical stump infection)
- Infectious emergency
- The umbilical vessels in a newborn are central conduits to rapidly spread infection
- Presents with Cellulitis in the region of umbilical stump
-
Umbilical Hernia
- Usually closes by age 2 to 3 years
- Surgery indications
- Defect exceeds 3 cm
- Hernia persists beyond age 5 years
- Delayed separation of the Umbilical Cord (>3 weeks)
- Urachal Anomaly
- Leukocyte adhesion defect
- Single Umbilical Artery
- Incidence: 1% of newborns
- Associated with renal anomalies, IUGR and prematurity
- In the past, renal Ultrasound was performed at 2 to 4 weeks of life
- No longer recommended in isolated Single Umbilical Artery cases (unless other indications)
- Deshpande (2009) Arch Dis Child Fetal Neonatal Ed 94(4):F265-7 [PubMed]
- Short Umbilical Cord
- Requires more vigilant evaluation
- Monitor closely in first year of life
- Careful exam for comorbid malformations
- Associated with increased morbidity and mortality
- Chromosomal abnormalities
- Gastrointestinal malformations
- Cardiopulmonary malformations
- Overall Relative Risk of death in first year: 2.4
- References
- Requires more vigilant evaluation
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Related Studies
Concepts | Sign or Symptom (T184) |
SnomedCT | 397320006 |
Spanish | trastorno del ombligo, trastorno de omblico (trastorno), trastorno del ombligo (trastorno), trastorno de omblico |
English | Problem;umbilicus, Disorder of umbilicus (disorder), Disorder of umbilicus, problem with umbilicus |
Ontology: Single umbilical artery (C1384670)
Definition (MSH) | Congenital abnormality where one, instead of the usual two, UMBILICAL ARTERY connects the fetus to the placenta. |
Concepts | Congenital Abnormality (T019) |
MSH | D058529 |
ICD10 | Q27.0 |
SnomedCT | 123277001, 63070006, 204470001 |
Italian | Arteria ombelicale singola, Arteria ombelicale unica, Cordone ombelicale a due vasi |
Japanese | 単一臍動脈, タンイツサイドウミャク |
Czech | Chybění pupeční arterie, jediná pupečníková tepna |
English | Two Vessel Cord, Single Umbilical Artery, Two Vessel Cords, Single Umbilical Arteries, Umbilical Artery, Single, Single Umbilical Artery [Disease/Finding], Two vessel cord, Two-vessel cord, single umbilical artery, umbilical cord complication - vascular anomalies single umbilical artery, single umbilical artery (diagnosis), Single artery AND vein of umbilical cord, Congenital absence of umbilical artery, Single umbilical artery (disorder), a.umbilicalis; single, artery; single umbilical, Single umbilical artery -RETIRED-, Single umbilical artery |
French | AOU (Artère Ombilicale Unique), Artère ombilicale unique, Cordon à deux vaisseaux |
German | Singulaere Nabelarterie, Singuläre Nabelschnurarterie, Singuläre Nabelarterie, Singulaere Nabelschnurarterie, Einzelnabelarterie |
Spanish | Arteria Umbilical Única, arteria umbilical única - RETIRADO - (concepto no activo), arteria umbilical única - RETIRADO -, arteria umbilical única (trastorno), arteria umbilical única, Arteria umbilical única |
Russian | ЕАП, ЕДИНСТВЕННАЯ АРТЕРИЯ ПУПОВИНЫ, PUPOCHNAIA ARTERIIA EDINSTVENNAIA, EAP, EDINSTVENNAIA ARTERIIA PUPOVINY, ПУПОЧНАЯ АРТЕРИЯ ЕДИНСТВЕННАЯ |
Portuguese | Artéria Umbilical Única, Artéria umbilicar única |
Hungarian | Egyetlen umbilicalis arteria |
Polish | Pojedyncza tętnica pępowinowa, Tętnica pępowinowa pojedyncza |
Norwegian | Enkel navlesnorarterie, Enkel navlearterie |
Dutch | a.umbilicalis; enkelvoudig, arterie; één enkele arteria umbilicalis, enkelvoudige navelstrengarterie |