Medial umbilical ligament

Anatomy and function

The medial umbilical ligament is the obliterated part of the umbilical artery that develops after birth. In the prenatal period, it constitutes the part of the umbilical artery that continues into the umbilical cord carrying deoxygenated and nutrient deficient blood to the placenta. After the umbilical cord is cut, the distal part of the artery becomes obliterated and gets replaced by fibrous tissue, becoming the medial umbilical ligament. It usually extends from the origin of the superior vesical artery to the umbilical ring on the anterior abdominal wall.

It is important to distinguish between the medial vs median umbilical ligaments. The medial umbilical ligament is the aforementioned paired structure related to the umbilical arteries, while the median umbilical ligament contains the urachus: the remnants of an embryonic communication between the allantois and cloaca.

The paired medial umbilical ligaments give rise to two of five folds of parietal peritoneum found along the anterior abdominal wall (the other members being the paired lateral umbilical folds and single median umbilical fold). The medial and median umbilical folds, form two peritoneal depressions, one on either side of the urinary bladder, referred to as the supravesical fossae. This area usually contains the fundus of the distended urinary bladder and can be clinically significant owing to the fact that the supravesical hernias can arise from there.

The main function of the medial umbilical ligament in postnatal life is to provide support for the urinary bladder, together with the median umbilical ligament. 

The medial umbilical ligament is particularly easy to see during the abdominal surgery procedures which is why it represents an important anatomic landmark for dissection not only of the pelvic lymph nodes but also of retropubic space (Retzius’ space).

To learn more about the peritoneum and its relations check out our other articles, videos, quizzes and labeled diagrams.