BMJ Case Reports 2017; doi:10.1136/bcr-2017-222664
  • Learning from errors

Umbilical artery perforation: a potentially life-threatening complication of umbilical artery catheterisation

  1. Frank van den Dungen1
  1. 1Department of Neonatology, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Pediatric Surgical Center of Amsterdam, Emma Children’s Hospital AMC & VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Daniel Molanus, danielmolanus{at}
  • Accepted 3 November 2017
  • Published 14 November 2017


Umbilical artery catheterisation is frequently performed in preterm or critically ill newborn infants for invasive monitoring of blood pressure and blood sampling for laboratory tests. It is associated with well-known complications like catheter-related infections, thromboembolic events and aneurysmal formation of the aorta. In this report, we present another major complication of umbilical artery catheterisation: umbilical artery perforation. This complication occurred in a prematurely born infant and resulted in severe haemorrhagic shock, subsequent renal failure and severe periventricular leukomalacia. Ultimately, the patient deceased 3 weeks after birth. Review of the literature identified only a few case reports and retrospective postmortem studies describing this complication. Neonatologists and paediatricians performing umbilical artery catheterisation should be aware of this rare, but potentially life-threatening complication.


  • Contributors Conception and design of the study: DM, MAGS, FAMD. Drafting the manuscript: DM. Revising the manuscript critically for important intellectual content: DM, MAGS, JPMD, FAMD. Approval of the version of the manuscript to be published: DM, MAGS, JPMD, FAMD.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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