SINGLE UMBILICAL ARTERY IS ASSOCIATED WITH AN INCREASED INCIDENCE OF STRUCTURAL AND CHROMOSOMAL ANOMALIES AND GROWTH RESTRICTION

2000 ◽  
Vol Volume 17 (Number 05) ◽  
pp. 229-232 ◽  
Author(s):  
Brian K. Rinehart ◽  
Dom A. Terrone ◽  
Christopher W. Taylor ◽  
Christy M. Isler ◽  
J. Elaine Larmon ◽  
...  
Author(s):  
Alaa Ebrashy

ABSTRACT US equipment became more and more important for the practicing obstetricians, and the demands for practicing US as part of the antenatal care becomes sometimes routine in certain areas. A lot of US workshops are practiced trying to put the guidelines for using the US in this domain, and every now and then new markers and US signs are added that could have some significance in relation to the fetal outcome. Here a problem now exists, which is the gap between the ability to detect and the understanding of the significance of these findings, and this of course creates a great deal of improper counseling which leads to anxiety and confusions. The aim of my lecture is to shed some light on some controversial US signs, like echogenic bowel, renal pyelectasis, cardiac echogenic foci, choroid plexus cyst, club foot, polydactyly, single umbilical artery and mild ventriculomegaly. First I shall discuss the epidemiology–the pathophysiology, underlying risk for associated chromosomal anomalies and the most important is the significance of these signs, if present alone, so trying to suit out an evidence-based approach to their management and to provide the clinician with all the data that enables him to properly counsel the parents and eliminates the confusion created by the mere detection of these findings.


Author(s):  
Nata Tifferet Willner ◽  
Tamar Wainstock ◽  
Asnat Walfisch ◽  
Eyal Sheiner ◽  
Daniella Landau ◽  
...  

Abstract Objective To determine whether isolated single umbilical artery (iSUA), even absent identifiable genitourinary (GU) abnormalities, increases the risk of GU infection during childhood. Study Design Retrospective population-based comparison of fetuses with iSUA versus normal three-vessel cords. Fetuses with growth restriction, prematurity, multiple gestations, and anatomical or chromosomal anomalies were excluded. The primary outcome was hospital-associated GU infection during the first 18 years of life. Kaplan–Meier's survival curves were used to assess cumulative risk; Cox's multivariable models were used to adjust for confounders. Results Among 227,599 term singleton deliveries, children with iSUA (n = 729) had a higher incidence (1.8 vs. 0.6%, p < 0.001) and cumulative incidence (log-rank test, p < 0.001) of hospital-associated GU infection. The Cox's models confirmed these findings (hazard ratio: >2.82, confidence interval: 1.63–4.87 in composite models). Conclusion iSUA represents an independent risk factor for GU infection. Urinary tract imaging may be warranted.


2016 ◽  
Vol 1 (1) ◽  

The Umbilical Artery Unica is found in 0.2 to 1.1% of all fetuses. Their presence of AOU in itself does not cause any harm to the fetus and newborn. Sometimes, however, this abnormality occurs associated with chromosomal abnormalities and other abnormalities Structural. The chromosomal abnormalities account for about 5-10%; the most common are trisomy 13, 18 and 21. The non-chromosomal anomalies associated together account for about 22%: heart disease is the most frequent. 4-6% of fetuses with AOU in isolation have minor abnormalities at birth, whose ultrasound diagnosis is difficult or impossible. 25-30% of fetuses with AOU are suffering from intrauterine growth retardation (IUGR), and about a quarter of these born prematurely. Fetuses with AOU also feature a higher risk of death intrauterine and / or intrapartum.


2020 ◽  
Vol 56 (S1) ◽  
pp. 245-246
Author(s):  
S. Amylidi‐Mohr ◽  
C. Hecht ◽  
B. Mosimann ◽  
J. Zdanowicz ◽  
D. Surbek ◽  
...  

2020 ◽  
Vol 11 (4) ◽  
pp. 217-222
Author(s):  
Nazan Eras

Fetuses with a single umbilical artery have a risk of increased chromosomal anomalies and congenital malformations. Ring chromosomes are rare and the phenotypic and clinical characteristics of affected individuals show great variability depending on the quantity of the lost critical genes or gains during the formation of the ring or due to mitotic instability. Ring chromosome 18 [r(18)] is characterized by short stature, craniofacial dysmorphism, mental and motor retardation, autoimmune disorders, extremity anomalies, dermal lesions, structural heart malformations, and kidney abnormalities. In this study, the clinical findings of a female patient who had a single umbilical artery in the prenatal period and was diagnosed as de novo r(18) by molecular karyotype analysis were compared with those in the literature. A detailed ultrasonographic examination of the fetus with a single umbilical artery may enable the detection of additional anomalies and thus the early diagnosis of chromosomal anomalies may be possible with prenatal genetic analysis.


2021 ◽  
Vol 58 (S1) ◽  
pp. 79-79
Author(s):  
E. Contro ◽  
L. Larcher ◽  
M. Valeriani ◽  
G. Michelli ◽  
J. Lenzi ◽  
...  

2014 ◽  
Vol 60 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Lorena Mesquita Caldas ◽  
Adolfo Liao ◽  
Mário Henrique Carvalho ◽  
Rossana Pulcineli Vieira Francisco ◽  
Marcelo Zugaib

Objective: To examine birth weight in pregnancies with isolated single umbilical artery (ISUA). Methods: Case control study with retrospective review of 131 singleton pregnancies with isolated single umbilical artery diagnosed before birth. Control group consisted of 730 singleton pregnancies recruited prospectively, that had histological confirmation of a 3 vessels cord. Pregnancies were classified as uncomplicated or high-risk according to the presence of diseases that increase the risk of placental insufficiency during pregnancy. Mean birth weight and frequency of low birth weight (< 2.500 g), very low birth weight (< 1.500 g) and fetal growth restriction below the 5th and 10th centiles were compared between groups. Results: Mean birth weight difference between ISUA (n=131, 2840±701g) and control (n=730, 2.983 ± 671g) pregnancies was 143g (95% CI= 17-269; p=0.04) and birth weight below the 5thcentile was significantly more common in ISUA group [28/131 (21.4%) versus 99/730 (13.6%), p=0.02]. When only uncomplicated pregnancies were considered in both groups, no birth weight differences were observed. Amongst high-risk subgroups, birth weight below the 5th centile remained significantly more common in ISUA compared to control pregnancies [10/35 (28.6%) versus 53/377 (14.1%), p=0.04]. Conclusion: Isolated single umbilical artery does not increase the risk of fetal growth restriction in uncomplicated singleton pregnancies.


2014 ◽  
Vol 17 (6) ◽  
pp. 584-588 ◽  
Author(s):  
Thomas J. Cade ◽  
Fabricio Da Silva Costa ◽  
Karen Reidy ◽  
Lex W. Doyle ◽  
Sarah E. Mitchell ◽  
...  

To determine the prognosis of an isolated single umbilical artery (SUA) in a twin pregnancy, we selected twin pregnancies with a second trimester ultrasound diagnosing a SUA in at least one fetus at our tertiary hospital. This was confirmed by placental histopathology or by expert review of ultrasound images. Cases were identified by searching the hospital ultrasound database over a period of 7.5 years. Higher order multiples or coexistent aneuploidy or major anomalies were excluded. Each case of an isolated SUA was assigned three consecutive twin pregnancy controls paired for chorionicity and maternal age. Primary outcomes were preterm birth <34 weeks, small for gestational age (SGA) or perinatal death. Other outcomes included antenatal growth restriction, mode of delivery, and admission to neonatal intensive care or special care nursery. Nine pregnancies (18 fetuses) were identified for analysis as cases. Isolated SUA was associated with preterm birth <34 weeks (odds ratio = 12.2; 95% CI = 2.0–75.2; p = .005) but not for SGA. There was also no difference in SGA between the affected twin and its normal co-twin. Perinatal death was increased but after controlling for gestational age and clustering this finding was no longer significant. We conclude that isolated SUA in twins adds a degree of risk to an already high-risk pregnancy but does not increase the need for surveillance for growth restriction.


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