VCOM Research Day Program Book 2023

Medical Student Research Educational

03 Umbilical Cord Dissection of a Human Fetal Cadaver

Trent Kite; Terry C Hrubec Corresponding author: tkite@vt.vcom.edu

Edward Via College of Osteopathic Medicine- Virginia Campus

The human placenta is the interface between mother and fetus. The umbilical cord acts as an essential conduit between the placenta and developing fetus. The cord facilitates life by delivering oxygenated blood and nutrients to the fetus, while transporting waste products and deoxygenated blood from the fetus to the placenta. Anatomical and physiological understanding of the umbilical cord is critical in understanding its clinical applications. Neonatal resuscitation often involves injection of the cord with a venous catheter as an alternative to central venous catheter, and intraosseous cannulas. Additionally, percutaneous umbilical cord sampling, also known as cordocentesis is a critical diagnostic method for the prediction of genetic abnormalities of a newborn. Finally, cord blood is being used experimentally given that it represents a rich and readily available

source of undifferentiated stem cells. These umbilical cord mesenchymal stem cells are being used to treat osteoarthritis and various autoimmune diseases. Each of these applications entails manipulation and injection of the cord, thus a detailed understanding of its anatomy and effects on fetal circulation are critical for safely delivering medical interventions. Fetal circulation is a difficult concept for medical students to conceptualize. To facilitate student visualization and understanding of blood flow between the fetus and placenta, a dissection was conducted to display fetal circulation. A primary incision was made at the midaxillary line immediately inferior to the costal margin on the left side of the fetus down to the left Anterior Superior Iliac Spine (ASIS). Scissors were used to facilitate manual reflection of the skin to the contralateral side of the body to reveal the underlying

viscera of the abdomen and pelvis. Peritoneum was bluntly dissected, and visceral organs revealed. Once the underlying viscera were liberated of the peritoneum and fascia, the two umbilical arteries were followed to their origin at the internal iliac arteries. The liver was bisected at the entry point of the umbilical vein to reveal the attachment of the umbilical vein with the Inferior Vena Cava (IVC) via the Ductus Venosus. This project's completion will assist first year medical students in understanding fetal anatomy and circulation in both the fetus and umbilical cord. The fetus was donated anonymously to VCOM’s anatomy program. The project is IRB exempt.

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