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Still, there remain a number of patterns of malformation whose pathogenesis has not been established. Six such patterns of malformation are sirenomelia, VACTERL association, OEIS complex, limb\u2010body wall defect (LBWD), urorectal septum malformation (URSM) sequence, and MURCS association, all of which predominantly affect caudal structures. On the basis of the overlap of the component malformations, the co\u2010occurrence in individual fetuses, and the findings on fetal examination, a common pathogenesis is proposed for these patterns of malformation. The presence of a single artery in the umbilical cord provides a visible clue to the pathogenesis of all cases of sirenomelia and 30%\u201350% of cases of VACTERL association, OEIS complex, URSM sequence, and LBWD. The single artery is formed by a coalescence of arteries that supply the yolk sac, arises from the descending aorta high in the abdominal cavity, and redirects blood flow from the developing caudal structures of the embryo to the placenta. This phenomenon during embryogenesis is termed vitelline vascular steal.<\/jats:p>","DOI":"10.1002\/ajmg.a.62103","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T06:31:14Z","timestamp":1612161074000},"page":"1379-1387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Common pathogenesis for sirenomelia, <scp>OEIS<\/scp> complex, <scp>limb\u2010body<\/scp> wall defect, and other malformations of caudal structures"],"prefix":"10.1002","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1806-6345","authenticated-orcid":false,"given":"Roger E.","family":"Stevenson","sequence":"first","affiliation":[{"name":"Greenwood Genetic Center J. C. 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