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Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes

Year 2015, Volume: 20 Issue: 2, 86 - 90, 10.07.2015

Mehmet Sakar İsmet Gun Bulent Demir Sureyya Demir Ali Zebitay

Abstract

Single umbilical artery (SUA) is one of the most common abnormality of umbilical cord. SUA is associated with congenital anomalies, chromosomal abnormalities and adverse perinatal outcomes including preterm birth and small for gestational age (SGA). In this study, we presented the management and perinatal outcomes of cases with SUA. Fifteen patients with SUA were enrolled to the study. SUA was diagnosed by detailed ultrasonographic examination in the 2nd trimester. We diagnosed SUA when a cross-sectional image of the umbilical cord demonstrated only 2 vessels and/or in oblique transverse section the use of color flow mapping to visualize the one of two umbilical arteries at adjacent to the fetal bladder. Entire fetuses with SUA underwent to detailed ultrasonographic examination. Demographic characteristics and perinatal outcomes were recorded. Fetal karyotyping was performed to the cases with additional ultrasonographic findings or risk factors. The median maternal age was 26,4 years (21-33 years). Of the 15 cases with SUA, one case had major anomaly and another case had two umbilical cord cysts. Fetal karyotyping was performed to 4 cases. No abnormal finding was observed in fetal karyotyping. Thirteen patients had isolated SUA. Of the 13 cases, 1 case was resulted with medical abortion, 1 case underwent to preterm birth, 1 case had oligohydramnios, three cases were resulted with SGA. In conclusion, vast majority of SUA cases are isolated. There is not adequate evidence about the association of isolated SUA with chromosomal abnormalities. However patients with isolated SUA should be followed up for possible adverse perinatal outcomes.

Keywords: Single umbilical artery, ultrasonography, management, perinatal outcome.

 

Keywords

single umbilical artery ultrasonography management perinatal outcome 

References

  • Qingxian C, Cuihua C, Mei Z, et al. Prenatal Diagnosis of single umbilical artery: implications for chromosomal abnormalities and neonatal outcome. J South Med Univ 2013; 33: 451-453.
  • Hill LM, Wibner D, Gonzales P, Chenevey P. Validity of transabdominal sonography in the detection of a two-vessel umbilical cord. Obstet Gynecol 2001; 98: 837-842.
  • 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: 567-570.
  • Stout MJ, Odibo AO, Longman R, Shanks AL, Cahill AG. The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes. Prenat Diagn 2013; 33: 269-272.
  • Volpe G, Volpe P, Boscia FM, et al. ‘Isolated’ single umbilical artery: incidence, cytogenetic abnormalities, malformation and perinatal outcome. Minerva Ginecol 2005; 57: 189-198.
  • Granese R, Coco C, Jeanty P. The value of single umbilical artery in the prediction of fetal aneuploidy: findings in 12,672 pregnant women. Ultrasound Q 2007; 23: 117-121.
  • Thummala MR, Raju TN, Langenberg P. Isolated single umbilical artery anomaly and the risk for congenital malformations: a meta-analysis. J Pediatr Surg 1998; 33: 580-585.
  • Kondi-Pafiti A, Kleanthis KC, Mavrigiannaki P, et al. Single umbilical artery: fetal and placental histopathologic alanalysis of 24 cases. Clin Exp Obstet Gynecol 2011; 38: 214-216.
  • Dagklis T, Defigueiredo D, Staboulidou I, Casagrandi D, Nicolaides KH. Isolated single umbilical artery and fetal karyotype. Ultrasound Obstet Gynecol 2010; 36: 291-295.
  • Sherer DM, Khoury-Collado F, Dalloul M, et al. Recurrent antepartum compression of a single artery double nuchal cord necessitating emergency cesarean delivery. Am J Perinatol 2005; 22: 437-440.
  • Mu SC, Lin CH, Chen YL, et al. The perinatal outcomes of asymptomatic isolated single umbilical artery in full-term neonates. Pediatr Neonatol 2008; 49: 230-233.
  • Horton AL, Barroilhet L, Wolfe HM. Perinatal outcomes in isolated single umbilical artery. abnormalities, malformation and perinatal outcome. Am J Perinatol. 2010; 27: 321-324.
  • Hua M, Odibo AO, Macones GA, et al. Single umbilical artery and its associated findings. Obstet Gynecol 2010; 115: 930-934.
  • Murphy-Kaulbeck L, Dodds L, Joseph KS, Van den Hof M. Single umbilical artery risk factors and pregnancy outcomes. Obstet Gynecol 2010; 116: 843- 850.
  • 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: 191-194.
  • Abuhamad AZ, Shaffer W, Mari G, et al. Single umbilical artery: Does it matter which artery is missing? Am J Obstet Gynecol 1995; 173: 728-732 .
  • Jiang Y, Li XH, Yang TZ. The impact of different sides of the absent umbilical artery on fetal growth in an isolated single umbilical artery. Arch Gynecol Obstet 2013; 288: 531-536.

Year 2015, Volume: 20 Issue: 2, 86 - 90, 10.07.2015

Mehmet Sakar İsmet Gun Bulent Demir Sureyya Demir Ali Zebitay

Abstract

References

  • Qingxian C, Cuihua C, Mei Z, et al. Prenatal Diagnosis of single umbilical artery: implications for chromosomal abnormalities and neonatal outcome. J South Med Univ 2013; 33: 451-453.
  • Hill LM, Wibner D, Gonzales P, Chenevey P. Validity of transabdominal sonography in the detection of a two-vessel umbilical cord. Obstet Gynecol 2001; 98: 837-842.
  • 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: 567-570.
  • Stout MJ, Odibo AO, Longman R, Shanks AL, Cahill AG. The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes. Prenat Diagn 2013; 33: 269-272.
  • Volpe G, Volpe P, Boscia FM, et al. ‘Isolated’ single umbilical artery: incidence, cytogenetic abnormalities, malformation and perinatal outcome. Minerva Ginecol 2005; 57: 189-198.
  • Granese R, Coco C, Jeanty P. The value of single umbilical artery in the prediction of fetal aneuploidy: findings in 12,672 pregnant women. Ultrasound Q 2007; 23: 117-121.
  • Thummala MR, Raju TN, Langenberg P. Isolated single umbilical artery anomaly and the risk for congenital malformations: a meta-analysis. J Pediatr Surg 1998; 33: 580-585.
  • Kondi-Pafiti A, Kleanthis KC, Mavrigiannaki P, et al. Single umbilical artery: fetal and placental histopathologic alanalysis of 24 cases. Clin Exp Obstet Gynecol 2011; 38: 214-216.
  • Dagklis T, Defigueiredo D, Staboulidou I, Casagrandi D, Nicolaides KH. Isolated single umbilical artery and fetal karyotype. Ultrasound Obstet Gynecol 2010; 36: 291-295.
  • Sherer DM, Khoury-Collado F, Dalloul M, et al. Recurrent antepartum compression of a single artery double nuchal cord necessitating emergency cesarean delivery. Am J Perinatol 2005; 22: 437-440.
  • Mu SC, Lin CH, Chen YL, et al. The perinatal outcomes of asymptomatic isolated single umbilical artery in full-term neonates. Pediatr Neonatol 2008; 49: 230-233.
  • Horton AL, Barroilhet L, Wolfe HM. Perinatal outcomes in isolated single umbilical artery. abnormalities, malformation and perinatal outcome. Am J Perinatol. 2010; 27: 321-324.
  • Hua M, Odibo AO, Macones GA, et al. Single umbilical artery and its associated findings. Obstet Gynecol 2010; 115: 930-934.
  • Murphy-Kaulbeck L, Dodds L, Joseph KS, Van den Hof M. Single umbilical artery risk factors and pregnancy outcomes. Obstet Gynecol 2010; 116: 843- 850.
  • 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: 191-194.
  • Abuhamad AZ, Shaffer W, Mari G, et al. Single umbilical artery: Does it matter which artery is missing? Am J Obstet Gynecol 1995; 173: 728-732 .
  • Jiang Y, Li XH, Yang TZ. The impact of different sides of the absent umbilical artery on fetal growth in an isolated single umbilical artery. Arch Gynecol Obstet 2013; 288: 531-536.
There are 17 citations in total.

Details

Primary Language English
Journal Section Articles
Authors

Mehmet Sakar

İsmet Gun

Bulent Demir This is me

Sureyya Demir This is me

Ali Zebitay This is me

Publication Date July 10, 2015
Published in Issue Year 2015 Volume: 20 Issue: 2

Cite

APA Sakar, M., Gun, İ., Demir, B., Demir, S., et al. (2015). Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes. EASTERN JOURNAL OF MEDICINE, 20(2), 86-90.
AMA Sakar M, Gun İ, Demir B, Demir S, Zebitay A. Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes. EASTERN JOURNAL OF MEDICINE. July 2015;20(2):86-90.
Chicago Sakar, Mehmet, İsmet Gun, Bulent Demir, Sureyya Demir, and Ali Zebitay. “Ultrasonographic Screening of Single Umbilical Artery: Management and Perinatal Outcomes”. EASTERN JOURNAL OF MEDICINE 20, no. 2 (July 2015): 86-90.
EndNote Sakar M, Gun İ, Demir B, Demir S, Zebitay A (July 1, 2015) Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes. EASTERN JOURNAL OF MEDICINE 20 2 86–90.
IEEE M. Sakar, İ. Gun, B. Demir, S. Demir, and A. Zebitay, “Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes”, EASTERN JOURNAL OF MEDICINE, vol. 20, no. 2, pp. 86–90, 2015.
ISNAD Sakar, Mehmet et al. “Ultrasonographic Screening of Single Umbilical Artery: Management and Perinatal Outcomes”. EASTERN JOURNAL OF MEDICINE 20/2 (July 2015), 86-90.
JAMA Sakar M, Gun İ, Demir B, Demir S, Zebitay A. Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes. EASTERN JOURNAL OF MEDICINE. 2015;20:86–90.
MLA Sakar, Mehmet et al. “Ultrasonographic Screening of Single Umbilical Artery: Management and Perinatal Outcomes”. EASTERN JOURNAL OF MEDICINE, vol. 20, no. 2, 2015, pp. 86-90.
Vancouver Sakar M, Gun İ, Demir B, Demir S, Zebitay A. Ultrasonographic screening of single umbilical artery: Management and perinatal outcomes. EASTERN JOURNAL OF MEDICINE. 2015;20(2):86-90.