The umbilical artery is a branch of the anterior division of the internal iliac artery. Before birth the paired umbilical arteries carry deoxygenated blood from the fetus to the placenta. After birth the proximal part remains open and gives the superior vesical arteries, while the distal part closes to form the medial umbilical ligament.
| Origin | Anterior division of the internal iliac artery |
|---|---|
| Course | Runs forward along the lateral pelvic wall and then on the side of the bladder; after birth the proximal part stays patent while the distal part becomes the medial umbilical ligament, running up the anterior abdominal wall to the umbilicus |
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The obliterated umbilical artery (medial umbilical ligament) is a key landmark in laparoscopic pelvic and inguinal surgery and in pelvic lymph node dissection. In newborns the umbilical artery is used for arterial catheterisation, which can be complicated by thrombosis or embolism. A single umbilical artery in the umbilical cord is associated with an increased risk of fetal anomalies.
Thrombosis, embolism or vasospasm in neonates with an umbilical arterial line, leading to limb, bowel or renal ischaemia that needs prompt catheter removal.
Absence of one umbilical artery in the cord, associated with renal and cardiac anomalies and growth restriction, prompting detailed fetal ultrasound.
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