Fetus with a single umbilical artery
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Katedra i Klinika Położnictwa i Patologii Ciąży, Uniwersytet Medyczny w Lublinie
Med Og Nauk Zdr. 2011;17(4):197–201
The normal umbilical cord contains two arteries and a single vein. A single umbilical artery (SUA) is the most common umbilical pathology in humans and occurs in approximately 0.2-1% of pregnancies. The SUA usually occurs as an isolated defect; however; a relationship has been confirmed between this abnormality and various fetal malformations, such as abnormalities concerning the musculoskeletal, urogenital, alimentary and cardiovascular systems. In addition, concomitant chromosomal abnormalities and intrauterine growth retardation (IUGR) are common in fetuses with SUA. SUA is an independent risk factor of perinatal mortality, and its high percentage (up to 25%) is associated with prematurity. Ultraso- nography is the principal diagnostic technique for identifying the structural abnormalities of the umbilical cord. In recent years, the detectibility of the SUA has increased, together with the development of ultrasonographic techniques. Color Doppler Imaging is extremely useful in the assessment of the structure of the umbilical cord, and should be an inseparable element of ultrasonographic imaging performed between weeks 18-22 of pregnancy. The diagnosis of the SUA should be associated with deepened diagnostics and intensified monitoring of the normal development and wellbeing of the fetus. After delivery, a comprehensive assessment of a newborn should be performed by a neonatologist. The study presents current knowledge concerning a two-vessel umbilical cord, the diagnostic methods available, and the effect of this abnormality on the course of pregnancy.

Heifi tz S A. Single umbilical artery: a statistical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol 1984;8:345- 78.
Geipel A, Germer U, Welp T, Schwinger E, Gembruch U. Prenatal diagnosis of single umbilical artery: determination of the absent side, associated anomalies, Doppler fi ndings and perinatal outcome. Ultrasound Obstet Gynecol 2000;15(2):114-7.
Nyberg DA, Mahony BS, Luthy D, Kapur R. Single umbilical artery. Prenatal detection of concurrent anomalies. J Ultrasound Med 1991; 10(5):247-53.
Hua M, Odibo AO, Macones GA, Roehl KA, Crane JP, Cahill AG. Single umbilical artery and its associated fi ndings. Obstet Gynecol 2010;115(5):930-4.
Dudiak C.M, Salomon C.G, Posniak H.V, Olson M.C, Flisak M.E. Sonography of the umbilical cord. Radiographics 1995;15(5):1035-1050.
Blackburn W. Cooley W. Umbilical cord. Human Malformations and Related Anomalies 1993;2:1275-350.
Lacro RV, Jones KL, Benirschke K. Th e umbilical cord twist: origin, direction, and relevance. Am J Obstet Gynecol 1987;157(4):833-8.
Romero R, Pilu G, Jeanty P, Ghidini A, Hobbins JC. Single umbilical artery. In: Prenatal Diagnosis of Congenital Anomalies, 1998; 387 (Norwalk: Appleton and Lange).
Leung AKC, Robson WLM. Single umbilical artery. Am J Dis Child 1989;143:108-11.
Lilia M I. Infants with single umbilical artery studied in a national registry. General epidemiological characteristics. Paediatr Perinat Epidemiol 1991;1:27-36.
Herrmann UJ Jr, Sidiropoulos D. Single umbilical artery: prenatal fi ndings. Prenat Diagn 1988;8(4):275-80.
Persutte WH, Hobbins J. Single umbilical artery: a clinical enigma in modern prenatal diagnosis. Ultrasound Obstet Gynecol 1995;6:216- 229.
Csecsi K, Kovacs T, Hinchliff e SA, Papp Z. Incidence and associations of single umbilical artery in prenatally diagnosed malformed, midtrimester fetuses: a review of 62 cases. Am J Med Genet 1992;43:524-30.
Byrne J, Blanc WA. Malformation and chromosomal anomalies in spontaneously aborted fetuses with single umbilical artery. Am J Obstet Gynecol 1985;151:340-2.
Jones TB, Sorokin Y, Bhatia R, Zador IE, Bottoms SF. Single umbilical artery: accurate diagnosis? Am J Obstet Gynecol 1993;169(3):538-40.
Feldstein VA, Harris RD, Machin GA. Ultrasound evaluation of the placenta and umbilical cord. W: Callen P.(Red). Ultrasonography in obstetrics and gynecology. Wyd.5. Saunders Elsevier, Philadephia 2008: 721-755.
Fujikura T. Fused umbilical arteriae near placental cord insertion. Am J Obstet Gynecol 2003;188:765-770.
Persutte WH, Lenke RR. Transverse umbilical arterial diameter: technique for the prenatal diagnosis of single umbilical artery. J Ultrasound Med 1994;13(10):763-6.
Kalish RB, Hunter T, Sharma G, Baergen RN. Clinical signifi cance of the umbilical cord twist. Am J Obstet Gynecol 2003;189(3):736-9.
Benirschke K, Brown WH. A vascular anomaly of the umbilical cord; the absence of one umbilical artery in the umbilical cords of normal and abnormal fetuses. Obstet Gynecol 1955; 6(4): 399-404.
Merz E. Ultrasound in obstetrics and gynecology. New York, NY: Thieme 2005;35:404.
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.
Abuhamad AZ, Shaff er W, Mari G, Copel JA, Hobbins JC, Evans AT. Single umbilical artery: does it matter which artery is missing? Am J Obstet Gynecol 1995;173:728-32.
Saller DN Jr, Keene CL, Sun CC, Schwartz S.Th e association of single umbilical artery with cytogenetically abnormal pregnancies. Am J Obstet Gynecol 1990;163(3):922-5.
Horton AL, Barroilhet L, Wolfe HM. Perinatal outcomes in isolated single umbilical artery. Am J Perinatol 2010;27(4):321-4. Epub 2009 Oct 24.
Burshtein S, Levy A, Holcberg G, Zlotnik A, Sheiner E. Is single umbilical artery an independent risk factor for perinatal mortality? Arch Gynecol Obstet 2009;19 [w druku].
Sepulveda WH. Antenatal sonographic detection of single umbilical artery. J Perinat Med 1991;19(5):391-5.