Neonatal bladder injury occurring after umbilical artery catheterization by cutdown

Umbilical artery catheterization is a widely used technique for monitoring sick neonates. When it is performed by cutdown, the proximity of peritoneum, urachus, and bladder makes these structures vulnerable to injury. Three neonates experienced bladder perforation that resulted from umbilical artery catheterization by cutdown. The diagnosis was aided by measuring electrolyte levels in the umbilical fluid and was confirmed by cystography. Conservative treatment was successful in one neonate, but two required operative repair of the bladder laceration.