How to cite this article: Duesterhoeft SM, Ernst LM, Siebert JR, Kapur RP. 2007. Five cases of caudal regression with an aberrant abdominal umbilical artery: Further support for a caudal regression–sirenomelia spectrum. Am J Med Genet Part A 143A:3175–3184.
Five cases of caudal regression with an aberrant abdominal umbilical artery: Further support for a caudal regression–sirenomelia spectrum†
Article first published online: 26 OCT 2007
Copyright © 2007 Wiley-Liss, Inc.
American Journal of Medical Genetics Part A
Special Issue: M. Michael Cohen Jr. Festschrift
Volume 143A, Issue 24, pages 3175–3184, 15 December 2007
How to Cite
Duesterhoeft, S. M., Ernst, L. M., Siebert, J. R. and Kapur, R. P. (2007), Five cases of caudal regression with an aberrant abdominal umbilical artery: Further support for a caudal regression–sirenomelia spectrum. Am. J. Med. Genet., 143A: 3175–3184. doi: 10.1002/ajmg.a.32028
- Issue published online: 28 NOV 2007
- Article first published online: 26 OCT 2007
- Manuscript Accepted: 31 JUL 2007
- Manuscript Received: 19 APR 2007
- caudal regression;
- umbilical artery;
- vascular steal
Sirenomelia and caudal regression have sparked centuries of interest and recent debate regarding their classification and pathogenetic relationship. Specific anomalies are common to both conditions, but aside from fusion of the lower extremities, an aberrant abdominal umbilical artery (“persistent vitelline artery”) has been invoked as the chief anatomic finding that distinguishes sirenomelia from caudal regression. This observation is important from a pathogenetic viewpoint, in that diversion of blood away from the caudal portion of the embryo through the abdominal umbilical artery (“vascular steal”) has been proposed as the primary mechanism leading to sirenomelia. In contrast, caudal regression is hypothesized to arise from primary deficiency of caudal mesoderm. We present five cases of caudal regression that exhibit an aberrant abdominal umbilical artery similar to that typically associated with sirenomelia. Review of the literature identified four similar cases. Collectively, the series lends support for a caudal regression–sirenomelia spectrum with a common pathogenetic basis and suggests that abnormal umbilical arterial anatomy may be the consequence, rather than the cause, of deficient caudal mesoderm. © 2007 Wiley-Liss, Inc.