Detection of single umbilical artery in the first trimester ultrasound: its value as a marker of fetal malformation

Abstract

Introduction: The value of a single umbilical artery (SUA) in first trimester ultrasound is not well established. The aim of our study was to determinate the relevance of diagnosis of single umbilical artery in first trimester ultrasound as an early marker suggesting the presence of malformations or associated chromosomopathies.

Material and methods: Retrospective study of clinical cases of SUA diagnosed at the University Hospital Puerta de Hierro in Madrid (Spain) during the first trimester ultrasound between September 2008 and September 2012.

Results: Prevalence of SUA was 1.1% in single pregnancies and 3.3% in twin pregnancies. Sensitivity, specificity, false positive rate, and false negative rate for the finding in the first trimester were 84.2, 99.8, 0.2, and 15.7%, respectively. 17.6% of cases had associated malformations. With an ultrasound in the 16th week most of the cases with significant fetal malformation were diagnosed.

Discussion: SUA is a useful marker in the first trimester for fetal malformation pathology, as it will allow detecting a large number of cases with malformations before 20 weeks of gestation.

Figure 1

Image at the level of the fetal pelvis. We can see both umbilical arteries are displayed surrounding the fetal bladder and going to the abdominal wall.

Figure 2

Image at the level of the fetal pelvis. We can see a single umbilical artery surrounding the fetal bladder.