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Umbilical cord has two arteries and one vein. The absence of one artery is referred to as single umbilical artery which could be because of primary agenesis of umbilical artery or atrophy or secondary atresia of the previously normally developed umbilical artery. The former is associated with foetal malformations and later can lead to haemodynamic changes in foetal circulation resulting in impaired foetal growth and its consequences. Histopathology of the umbilical cord is the gold standard for confirmation of the diagnosis.