Is routine follow-up ultrasound to assess fetal growth warranted with the isolated finding of a single umbilical artery on initial comprehensive fetal survey?

Of 39,773 white and black consecutive single births, 344 (0.9%) had single umbilical artery (SUA). The incidence was higher in whites (1.2%) than in blacks (0.5%). Despite high mortality in infants with SUA (14.0%) the incidence was still 0.7% among surviving infants. Associated malformations were present in 19 of 36 dead infants with SUA, or 52.8%, and in 11 of 266 SUA survivors, or 4.1%. Cardiovascular and genitourinary anomalies were not higher in dead infants with SUA compared to all dead malformed infants. A follow-up study of infants up to 4 years of age was undertaken, comparing 266 SUA survivors with 798 matched controls. Among malformations found in survivors, only inguinal hernia was significantly higher in SUA children compared to controls. The incidences of other specific abnormal conditions were not significantly different in the two groups. The mean values of body weight, body length, and head circumference at 4 months, 1 year, and 4 years of age, were almost equal in the two groups, as were the mental and motor scores at 8 months and the I.Q. at 4 years of age.

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Prenatal Diagnosis and Postnatal Follow-up of Patients with Persistent Right Umbilical Vein

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1231 ◽

2012 ◽

Vol 6 (1) ◽

pp. 104-108 ◽

Cited By ~ 4

Author(s):

Daniel Beovide Leal ◽

Magela Maggiolini ◽

Ana Bianchi

Keyword(s):

Prenatal Diagnosis ◽

Obstet Gynecol ◽

Umbilical Artery ◽

Umbilical Vein ◽

Falciform Ligament ◽

Good Growth ◽

Single Umbilical Artery ◽

Abdominal Perimeter ◽

A Prospective Study

ABSTRACT Objective Through a prospective study the incidence and neonatal results of patients with persistent right umbilical vein are evaluated. Materials and methods During the period between August 2009 and February 2011, 3,576 low-risk obstetric sonographies were performed by the same technician at four different centers of prenatal diagnosis. Persistent right umbilical vein was diagnosed during a customary ultrasound examination, in the abdominal transverse section used to measure abdominal perimeter. Patients were asked to bring their children several months after delivery for a clinical and sonographic evaluation. Results Persistent right umbilical vein was found in nine fetuses. In one case, it was associated with single umbilical artery. All fetuses had good growth and development. In some children, the postnatal sonography showed the gallbladder toward the left of falciform ligament. Conclusion The incidence of persistent right umbilical vein in this population was of 1:397. We did not find any association with severe malformations as mentioned in the first articles related to this topic. There was only one case with single umbilical artery. All newborns developed normally. The question is raised why, being this anomaly so frequent and obvious, it is not more often diagnosed. Gallbladder position in respect to falciform ligament is a finding to assess. How to cite this article Leal DB, Maggiolini M, Bianchi A. Prenatal Diagnosis and Postnatal Follow-up of Patients with Persistent Right Umbilical Vein. Donald School J Ultrasound Obstet Gynecol 2012;6(1):104-108.

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Fetal Growth Assessment and Neonatal Birth Weight in Fetuses With an Isolated Single Umbilical Artery

Obstetrics and Gynecology ◽

10.1097/01.aog.0000158108.51397.f5 ◽

2005 ◽

Vol 105 (5, Part 1) ◽

pp. 1093-1097 ◽

Cited By ~ 38

Author(s):

Mladen Predanic ◽

Sriram C. Perni ◽

Alexander Friedman ◽

Frank A. Chervenak ◽

Stephen T. Chasen

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Umbilical Artery ◽

Single Umbilical Artery ◽

Neonatal Birth Weight ◽

Growth Assessment

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Relationship of Isolated Single Umbilical Artery to Fetal Growth, Aneuploidy, and Perinatal Mortality

Obstetrical & Gynecological Survey ◽

10.1097/01.ogx.0000446905.25137.15 ◽

2014 ◽

Vol 69 (4) ◽

pp. 193-195

Author(s):

B.J. Voskamp ◽

H. Fleurke-Rozema ◽

K. Oude-Rengerink ◽

R.J.M. Snijders ◽

C.M. Bilardo ◽

...

Keyword(s):

Perinatal Mortality ◽

Fetal Growth ◽

Umbilical Artery ◽

Single Umbilical Artery ◽

Relationship Of

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FOLLOW-UP OF INFANTS WITH SINGLE UMBILICAL ARTERY

Obstetrical & Gynecological Survey ◽

10.1097/00006254-197403000-00012 ◽

1974 ◽

Vol 29 (3) ◽

pp. 201-203

Author(s):

LUZ A. FROEHLICH ◽

TOSHIO FUJIKURA

Keyword(s):

Umbilical Artery ◽

Single Umbilical Artery

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Prenatal Detection of Cardiac Anomalies in Fetuses with Single Umbilical Artery: Diagnostic Accuracy Comparison of Maternal-Fetal-Medicine and Pediatric Cardiologist

Journal of Pregnancy ◽

10.1155/2014/265421 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Ilir Tasha ◽

Rachel Brook ◽

Heidi Frasure ◽

Noam Lazebnik

Keyword(s):

Umbilical Artery ◽

Cardiac Anomaly ◽

Inclusion Criteria ◽

Single Umbilical Artery ◽

Maternal Fetal Medicine ◽

Fetal Medicine ◽

Cardiac Anomalies ◽

Accuracy Comparison ◽

Good Agreement

Aim. To determine agreement of cardiac anomalies between maternal fetal medicine (MFM) physicians and pediatric cardiologists (PC) in fetuses with single umbilical artery (SUA).Methods. A retrospective review of all fetuses with SUA between 1999 and 2008. Subjects were studied by MFM and PC, delivered at our institution, and had confirmation of SUA and cardiac anomaly by antenatal and neonatal PC follow-up. Subjects were divided into four groups: isolated SUA, SUA and isolated cardiac anomaly, SUA and multiple anomalies without heart anomalies, and SUA and multiple malformations including cardiac anomaly.Results. 39,942 cases were studied between 1999 and 2008. In 376 of 39,942 cases (0.94%), SUA was diagnosed. Only 182 (48.4%) met inclusion criteria. Cardiac anomalies were found in 21% (38/182). Agreement between MFM physicians and PC in all groups combined was 94% (171/182) (95% CI [89.2, 96.8]). MFM physicians overdiagnosed cardiac anomalies in 4.4% (8/182). MFM physicians and PC failed to antenatally diagnose cardiac anomaly in the same two cases.Conclusions. Good agreement was noted between MFM physicians and PC in our institution. Studies performed antenatally by MFM physicians and PC are less likely to uncover the entire spectrum of cardiac abnormalities and thus neonatal follow-up is suggested.

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Single umbilical artery ligation-induced fetal growth retardation: effect on postnatal adaptation

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1992.263.3.e575 ◽

1992 ◽

Vol 263 (3) ◽

pp. E575-E583 ◽

Cited By ~ 5

Author(s):

K. Oyama ◽

J. Padbury ◽

B. Chappell ◽

A. Martinez ◽

H. Stein ◽

...

Keyword(s):

Signal Transduction ◽

Fetal Growth ◽

Growth Retardation ◽

Umbilical Artery ◽

Physiological Stress ◽

Fetal Growth Retardation ◽

Signal Transduction System ◽

Single Umbilical Artery ◽

Artery Ligation ◽

Beta Adrenergic

To assess whether prolonged intrauterine stress and resultant fetal growth retardation result in depletion of adrenal catecholamines and alter the adrenergic signal transduction system, we studied newborn sheep after single umbilical artery ligation (SUAL)-induced growth retardation. The animals were delivered at term, and postnatal cardiovascular, pulmonary, endocrine, and metabolic responses were measured. We also evaluated the status of myocardial and pulmonary beta-adrenergic receptor number and function. SUAL caused significant growth retardation but relative preservation of brain and adrenal gland weight and adrenal catecholamine content. Blood pressure, plasma free fatty acid, and glucose responses at birth were blunted in SUAL animals. The plasma epinephrine (Epi) and norepinephrine levels were comparable in both groups for the first 2 h of age. By 4 h, both plasma concentration and plasma appearance rate of Epi were reduced to 40% of control in SUAL animals (P less than 0.05). Neither beta-receptor density, affinity, nor adenylate cyclase activity were altered by SUAL in either cardiac or pulmonary membranes. These results suggest that, rather than overt depletion, there is relative sparing of initial adrenal medullary function that later waned. This response and preservation of the beta-adrenergic signal transduction system may represent partial compensation for the physiological stress induced by SUAL.

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