Although a variety of neonatal arteriovenous fistulas have been described, including some between persistent fetal structures,1,2 this is the first observation of an umbilical artery-vein fistula. This fistula was probably produced by an indwelling umbilical vein catheter.
Report of a Case
A 6-week-old male infant presented to the cardiac clinic because of a "buzzing belly button." He was the product of 32 weeks gestation after induced labor because of premature rupture of the membranes. The birth weight was 1,700 gm (3 lb 15½ oz). The Apgar score at 5 minutes was 7, and the skin was meconium stained. Because of respiratory distress in the first day of life and an arterialized capillary pH of 7.23 and arterial carbon dioxide pressure (Pco2) of 52, an umbilical venous catheter was inserted for fluid and bicarbonate administration. The pH and Pco2 were normal the next day. Maximum bilirubin level was