Associated anomalies and perinatal outcome in fetuses with prenatally diagnosed single umbilical artery

Abstract

Objective: To evaluate pattern of associated structural anomalies, abnormal karyotypes and perinatal outcomes of fetuses with prenatally diagnosed single umbilical artery and to evaluate the relation of absent side of a single umbilical artery in association with anomalies and abnormal karyotypes.Materials and methods: Thirty fetuses with a single umbilical artery were detected by prenatal ultrasound examination between March 1998 and June 2001 at Eul‐Ji University Hospital. All medical records were reviewed for maternal demographics, associated anomalies, karyotypic analysis, pregnancy complications, and neonatal outcome.Results: Of the 30 fetuses, 11 (36.7%) were terminated because of severe anomalies and 1 (3.3%) experienced neonatal death. 17 fetuses (56.7%) had an associated structural anomaly. The structural anomalies found in association with single umbilical artery were multiple malformations (seven cases, 41.2%), cardiovascular anomalies (four cases, 23.5%), urinogenital anomalies (four cases, 23.5%), CNS anomalies (one case, 5.9%) and ectopia cordis (one case, 5.9%). Karyotype analysis was available in 25 cases and 5 of these were chromosomally abnormal. All of the karyotypically abnormal fetuses had a structural defect diagnosed on prenatal ultrasound examination in addition to the single umbilical artery. Of the 13 fetuses without any associated structural or chromosomal anomalies, 3 (23.1%) demonstrated growth restriction. Of the 26 cases identified, the absent side of a single umbilical artery, the right umbilical artery was absent in 13 (50%) and the left in 13 (50%) fetuses. The frequency with associated structural and chromosomal anomalies was equal on right (46.2, 15.4%) and left (69.2, 23.1%) sides.Conclusion: When single umbilical artery is detected, a detailed ultrasonographic examination and fetal karyotyping should be recommended for search of associated structural and chromosomal abnormalities. In cases, where single umbilical artery is an isolated finding on prenatal ultrasound, careful attention to fetal growth is necessary.