Supernumerary umbilical vein resulting in a four-vessel umbilical cord.

The birth of an infant with increased number of umbilical veins is a rare event and has been previously reported to be associated with a high incidence of major congenital anomalies. This report documents a normal infant with two umbilical veins resulting in a four vessel cord. A male infant (third of triplet pregnancy resulting from multiple zygote implantation) was born at 30 weeks' gestation weighing 1320 g.Two umbilical veins and two umbilical arteries were noted on cannulation and X ray. Physical examination and cranial, abdominal, and cardiac ultrasound exam were normal. One-year follow-up was normal. The birth of infant with a four-vessel cord mandates comprehensive workup for associated anomalies but this case indicates that such a finding is not always ominous.