E-ISSN: 2619-9467

Contents    Cover    Publication Date: 13 Apr 2021
Year 2021 - Volume 31 - Issue 1

Open Access

Peer Reviewed

ORIGINAL RESEARCH
1723 Viewed745 Downloaded

Retrospective Outcome of 30 Patients Prenatally Diagnosed with Single Umbilical Artery

Full Text PDF  
J Clin Obstet Gynecol. 2021;31(1):1-5
DOI: 10.5336/jcog.2020-78152
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Single umbilical artery (SUA) in fetus have shown to be associated with structural anomalies, chromosomal disorders and growth restiction. In this study, we aimed to present the obstetric outcomes in fetuses with SUA. Material and Methods: In this retrospective study, obstetric results of 30 patients diagnosed with SUA over a 2-year period were analyzed. Results: There were 30 cases of prenatally diagnosed SUA. Twenty eight patients had singleton pregnancies and 2 had dichorionic diamniotic twin pregnancies. The gestational week at the time of diagnosis varied between 15 and 24 weeks, with the mean week of diagnosis at 21 weeks. Additional ultrasonographic findings accompanying the SUA were detected in 13 patients (43%). Minor abnormalities (renal pelviectasia, choroid plexus cyst, persistant right umbilical vein) were detected in 4 patients in this group. More than one abnormality was detected in 7 fetuses. Structural abnormalities were distributed as follows: cardiovascular system abnormalities in 9 fetuses, musculoskeletal abnormalities in 3 fetuses, urogenital system abnormalities in 3 fetuses, central nervous system abnormalities in 4 fetuses and gastrointestinal system abnormalities in 2 fetuses. Chromosomal abnormalities were detected in 3 fetuses. Intrauterin growth restiriction was not detected in isolated SUA patients and also no chromosomal abnormality was detected in this group. Conclusion: Umbilical arteries of fetus should be checked during detailed ultrasound examination. Detailed fetal anatomic examination should include fetal echocardiography. During fetal echocardiography, fetal venous system must also carefully be examined.
REFERENCES:
  1. Geipel A, Germer U, Welp T, Schwinger E, Gembruch U. Prenatal diagnosis of single umbilical artery: determination of the absent side, associated anomalies, Doppler findings and perinatal outcome. Ultrasound Obstet Gynecol. 2000;15(2):114-7. [Crossref] [PubMed] 
  2. Hua M, Odibo AO, Macones GA, Roehl KA, Crane JP, Cahill AG. Single umbilical artery and its associated findings. Obstet Gynecol. 2010;115(5):930-4. [Crossref] [PubMed] 
  3. Persutte WH, Hobbins J. Single umbilical artery: a clinical enigma in modern prenatal diagnosis. Ultrasound Obstet Gynecol. 1995;6(3):216-29. [Crossref] [PubMed] 
  4. Heifetz SA. Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol. 1984;8(4):345-78. [PubMed] 
  5. Lilja GM. Single umbilical artery and maternal smoking. BMJ. 1991;302(6776):569-70. [Crossref] [PubMed] [PMC] 
  6. Burshtein S, Levy A, Holcberg G, Zlotnik A, Sheiner E. Is single umbilical artery an independent risk factor for perinatal mortality? Arch Gynecol Obstet. 2011;283(2):191-4. [Crossref] [PubMed] 
  7. Chow JS, Benson CB, Doubilet PM. Frequency and nature of structural anomalies in fetuses with single umbilical arteries. J Ultrasound Med. 1998;17(12):765-8. [Crossref] [PubMed] 
  8. Dagklis T, Defigueiredo D, Staboulidou I, Casagrandi D, Nicolaides KH. Isolated single umbilical artery and fetal karyotype. Ultrasound Obstet Gynecol. 2010;36(3):291-5. [Crossref] [PubMed] 
  9. Tülek F, Kahraman A, Taşkın S, Özkavukçu E, Söylemez F. Determination of risk factors and perinatal outcomes of singleton pregnancies complicated by isolated single umbilical artery in Turkish population. J Turk Ger Gynecol Assoc. 2015;16(1):21-4. [Crossref] [PubMed] [PMC] 
  10. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 101: Ultrasonography in pregnancy. Obstet Gynecol. 2009;113(2 Pt 1):451-61. [Crossref] [PubMed] 
  11. Jeanty P. Fetal and funicular vascular anomalies: identification with prenatal US. Radiology. 1989;173(2):367-70. [Crossref] [PubMed] 
  12. Rembouskos G, Cicero S, Longo D, Sacchini C, Nicolaides KH. Single umbilical artery at 11-14 weeks' gestation: relation to chromosomal defects. Ultrasound Obstet Gynecol. 2003;22(6):567-70. [Crossref] [PubMed] 
  13. Saller DN Jr, Keene CL, Sun CC, Schwartz S. The association of single umbilical artery with cytogenetically abnormal pregnancies. Am J Obstet Gynecol. 1990;163(3):922-5. [Crossref] [PubMed] 
  14. Jauniaux E. The single artery umbilical cord: it is worth screening for antenatally? Ultrasound Obstet Gynecol. 1995;5(2):75-6. [Crossref] [PubMed] 
  15. Dane B, Dane C, Kiray M, Cetin A, Yayla M. Fetuses with single umbilical artery: analysis of 45 cases. Clin Exp Obstet Gynecol. 2009;36(2): 116-9. [PubMed] 
  16. Özgün MT, Türkyılmaz Ç, Başbuğ M, Kaya D, Batuhan C. Prenatal sonographic diagnosis of single umbilical artery: evaluation of 23 cases. Turkiye Klinikleri J Gynecol Obst. 2009;19(2):75-80.
  17. Predanic M, Perni SC, Friedman A, Chervenak FA, Chasen ST. Fetal growth assessment and neonatal birth weight in fetuses with an isolated single umbilical artery. Obstet Gynecol. 2005;105(5 Pt 1):1093-7. [Crossref] [PubMed] 
  18. Voskamp BJ, Fleurke-Rozema H, Oude-Rengerink K, Snijders RJ, Bilardo CM, Mol BW, et al. Relationship of isolated single umbilical artery to fetal growth, aneuploidy and perinatal mortality: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2013;42(6):622-8. [Crossref] [PubMed] 
  19. Xu Y, Ren L, Zhai S, Luo X, Hong T, Liu R, et al. Association between isolated single umbilical artery and perinatal outcomes: a meta-analysis. Med Sci Monit. 2016;22:1451-9. [Crossref] [PubMed] [PMC]