Anat Cell Biol.  2022 Dec;55(4):467-474. 10.5115/acb.22.102.

Umbilical cord vessels other than the umbilical arteries and vein: a histological study of midterm human fetuses

• Kim JH
• Hayashi S
• Jin ZW
• Murakami G
• Rodríguez-Vázquez JF

• KMID: 2537466
• DOI: http://doi.org/10.5115/acb.22.102

Abstract

At birth, the umbilical cord contains various types of thin vessels that are near and outside the umbilicus and separate from the umbilical arteries and vein. These vessels are regarded as the remnant “vitelline vessels” and are often called “umbilical vessels”, although this terminology could lead to confusion with the true umbilical arteries and vein. No study has yet comprehensively examined these vessels using histological sections. Our examination of these vessels in 25 midterm fetuses (gestational age: 10–16 weeks) led to five major findings: (i) all specimens had umbilical branches of the inferior epigastric artery; (ii) 5 specimens had vitelline vein remnants; (iii) 4 specimens had a thin artery originating from the left hepatic artery that ran along the umbilical vein; (iv) 2 specimens had a so-called “para-umbilical vein” that was along the umbilical vein and reached the umbilicus; and (v) all specimens had lymphatic vessels originating from the umbilicus that ran caudally along the umbilical artery. The pelvic vein tributaries were well developed along the intra-abdominal umbilical artery, but did not reach the umbilicus. The lymphatic vessel was distinguished from the veins by an intraluminar cluster of lymphocytes attaching to the endothelium. The arterial branch in the umbilical cord did not accompany veins and lymphatic vessels, in contrast to the mother artery in the rectus abdominis. All these thin vessels seemed to be obliterated when the fibrous umbilical ring grew during late-term. The para-umbilical collateral vein in adults might develop outside the fibrous umbilical ring after birth.

Keyword

Umbilical cord; Umbilical arteries and vein; Para-umbilical vein; Inferior epigastric artery; Lymphatic vessels

Figure

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  Fig. 1 A thin artery running along the umbilical artery (UA) in the umbilical cord in sagittal sections of a fetus with a crown-rump length of 59 mm. Goldner-Masson trichrome staining. (A) Shows the most medial plane and (G) shows the most lateral plane. Panels (B), (D), and (F) are higher magnification views of the rectangles in (A), (C), and (E), respectively. The thin artery originates from the inferior epigastric artery in the upper rim of the umbilicus (A), and its 3 mm course is traceable along the upper margin of the wall of the UA (C, E). This artery is clearly outside the UA (F). (G) Shows veins that accompanied the UA, which does not reach the umbilicus. (A, C, E, G) Scale bars=1 mm; (B, D, F) scale bars=0.1 mm. RA, rectus abdominis; UB, urinary bladder; OV, ovary.

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  Fig. 2 Umbilical branch of the inferior epigastric artery and the vitelline vein remnant in horizontal sections of five fetuses with crown-rump length (CRL)s of 52 to 97 mm. (A–C, E, F) Azan staining. (D, G) H&E staining. (A, B) Fetus with CRL of 52 mm. (C, E) Fetus with CRL of 55 mm. (D) Fetus with CRL of 72 mm. (F) Fetus with CRL of 83 mm. (G) Fetus with CRL of 97 mm. Each panel contains the umbilical branch (artery) of the inferior epigastric artery. The remnant of the vitelline vein (VV) is present in two fetuses (A–C, E). (A–E) High magnification (scale bar in A=1 mm). (F, G) Low magnification (scale bar in F=1 mm). lymph, lymphatic vessels; AL, allantois; RA, rectus abdominis; UA, umbilical artery.

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  Fig. 3 VV remnant and umbilical branch of the inferior epigastric artery in sagittal sections of a fetus with a crown-rump length of 46 mm. H&E staining. (A) Shows a plane in the right-lateral side of (F). Panels (E) and (G, H) are higher magnification views of the rectangles in (D) and (F), respectively. The insert in the left-bottom of (C) shows the umbilical branch (artery) of the inferior epigastric artery (square in C). The remnant of the VV originates from the anterior surface of the PA (D), runs between the liver and transverse colon (TC in D) or between the liver and JE (D, F), and reaches the superior side of the umbilical artery (A–D). (E) Shows a candidate lymphatic vessel (lymph) along the umbilical artery at the umbilicus. Scale bars in A to D, F=1 mm; in C-insert, E, G, and H=0.1 mm. VV, vitelline vein; AL, allantois; RA, rectus abdominis; UA, umbilical artery; UV, umbilical vein; PA, pancreas; JE, jejunum.

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  Fig. 4 Superior and inferior epigastric arteries in sagittal sections of a fetus with a crown-rump length of 61 mm. H&E staining. The arrow in each panel indicates the most superior intersection of the rectus abdominis. (C) Magnified view of the rectangle in (B). (D) Magnified view of the rectangle in (A). (E) Magnified view of the rectangle in (D). The superior epigastric artery (sup.epig.a) approaches the intersection in (D), and the inferior epigastric artery (inf.epig.a) approaches the intersection in (C). Thus, the umbilicus is in the region of the inferior artery. (E) Shows the inferior epigastric artery and the accompanying veins and lymphatic vessels. (A, B) Low magnification (scale bar in A=1 mm). (C, D) High magnification (scale bar in D=1 mm). (E) Highest magnification (scale bar=0.1 mm).

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  Fig. 5 The paraumbilical vein, a thin artery along the umbilical vein (UV), and thick lymphatic vessels along the umbilical artery (UA) of four fetuses with crown-rump length (CRL) of 46 mm to 92 mm. Panels other than panel B, H&E staining; (B) Azan staining. (A) Shows a sagittal section of a fetus with a CRL of 46 mm CRL (same specimen a s in Fig. 3). (B) Shows a horizontal section of a fetus with a CRL of 92 mm. (C) Shows a horizontal section of a fetus with a CRL of 90 mm. (D–F) Show horizontal sections of a fetus with a CRL of 75 mm. (A) Shows a thin artery along the UV and a candidate lymphatic vessel (triangles) along the UA; the insert shows the thin artery (arrows) that originates from the left hepatic artery (LHA). The vein along the UV in panels A to C is the so-called “para-umbilical vein”. (D) Shows bilateral thick lymphatic vessels along the urinary bladder (UB). Panels E and F are higher magnification views of the rectangles in panel D, and show that the lymphatic vessels contain a cluster of primitive lymphocytes. Scale bars in A to D=1 mm; in E and F=0.1 mm. RA, rectus abdominis.

Reference

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