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. 2010 Oct;116(4):843-850.
doi: 10.1097/AOG.0b013e3181f0bc08.

Single umbilical artery risk factors and pregnancy outcomes

Lynn Murphy-Kaulbeck  1 , Linda Dodds, K S Joseph, Michiel Van den Hof
Affiliations

Single umbilical artery risk factors and pregnancy outcomes

Lynn Murphy-Kaulbeck et al. Obstet Gynecol. 2010 Oct.

Abstract

Objective: To identify risk factors for fetuses and neonates with single umbilical artery and isolated single umbilical artery (single umbilical artery in the absence of chromosomal abnormalities and structural abnormalities) and to assess whether there is an increased risk for complications during pregnancy, labor, and delivery, and for perinatal morbidity and mortality.

Methods: A population-based retrospective cohort analysis of deliveries in Nova Scotia, Canada, between 1980 and 2002 was conducted using the Nova Scotia Atlee Perinatal Database. Risk factors and outcomes for single umbilical artery and isolated single umbilical artery pregnancies were compared with three-vessel-cord pregnancies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each outcome using multiple logistic regression to adjust for confounding factors. Separate models were run for single umbilical artery and isolated single umbilical artery.

Results: There were 203,240 fetuses and neonates available for analysis, with 885 (0.44%) having single umbilical artery and 725 (0.37%) having isolated single umbilical artery. Single umbilical artery fetuses and neonates had a 6.77 times greater risk of congenital anomalies and 15.35 times greater risk of chromosomal abnormalities. The most common congenital anomalies in chromosomally normal fetuses and neonates were genitourinary (6.48%), followed by cardiovascular (6.25%) and musculoskeletal (5.44%). For isolated single umbilical artery, placental abnormalities (OR 3.63, 95% CI 3.01-4.39), hydramnios (OR 2.80, 95% CI 1.42-5.49), and amniocentesis (OR 2.52, 95% CI 1.82-3.51) occurred more frequently than with three vessel cords. Neonates with single umbilical artery and isolated single umbilical artery had increased rates of prematurity, growth restriction, and adverse neonatal outcomes.

Conclusion: Fetuses and neonates with single umbilical artery and isolated single umbilical artery are at increased risk for adverse outcomes. Identification of single umbilical artery is important for prenatal diagnosis of congenital anomalies and aneuploidy. Increased surveillance with isolated single umbilical artery may improve pregnancy outcomes.

Level of evidence: II.

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References

    1. Heifetz SA. Single umbilical artery: a statistical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol 1984;8:345–78.
    1. Byrne J, Blanc WA. Malformations and chromosome anomalies in spontaneously aborted fetuses with single umbilical artery. Am J Obstet Gynecol 1985;151:340–2.
    1. Prucka S, Clemens M, Craven C, McPherson E. Single umbilical artery: what does it mean for the fetus? A case-control analysis of pathologically ascertained cases. Genet Med 2004;6:54–7.
    1. Martinez-Payo C, Gaitero A, Tamarit I, Garcia-Espantaleon M, Iglesias Goy E. Perinatal results following the prenatal ultrasound diagnosis of single umbilical artery. Acta Obstet Gynecol Scand 2005;84:1068–74.
    1. Csécsei K, Kovács T, Hinchliffe 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.

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