Solution: A persistent right umbilical vein (UV) is a finding that is thought to be present in approximately 1:500 patients in a low risk population. It is often associated with a single umbilical artery (not in this case). When it is intrahepatic, you will see that the UV passes to the right of the gall bladder and curves towards the stomach (this is seen in this case). It fuses with the left portal vein and that is what gives it the characteristic appearance of curving into the left hepatic lobe towards the stomach. In this setting, the outcome is generally favorable. It can also be extra hepatic with the UV bypassing the liver anteriorly and draining into systemic veins. In this case, it is associated with aneuploidy and multiple anomalies and requires further evaluation (echo and high risk directed US). Whether or not an intrahepatic persistent right UV requires further evaluation is debatable. If there is any uncertainty about the heart, or other abnormalities, then the patient should probably be evaluated further, but if the screen is otherwise normal and these structures are well seen, then it would be reasonable to not perform further evaluation.