ANOMALIES ASSOCIATED WITH SINGLE UMBILICAL ARTERY

FETAL ANOMALIES

• "There is no known malformation or syndrome that is invariably associated with SUA" (1).
• Fetal anomalies, when present, have no consistent pattern.
• Malformations of virtually every organ system has been reported.
• Rate of malformations = 7-55% (1,2).
• There is no correlation between the side of the absent umbilical artery and the presence of fetal anomalies (3).
• Most common lesions are anaplastic lesions of the gastrointestinal and genitourinary tracts, while lesions of the central nervous system were least frequent.
• Table of reported fetal anomalies associated with SUA.
• Intrauterine growth retardation, low birth weight and prematurity
  

PLACENTAL ABNORMALITIES (4,5)

Low placental weight (most common placental abnormality). Placenta extrachorialis (marginata and circumvallate) Placenta biparta and succenturiate Placenta Previa Marginal cord insertion Velamentous cord insertion

9-57% 4-12% 3-7% 18% 9%

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SIDE DISTRIBUTION AND ASSOCIATED ANOMALIES

Ref	#cases	Absent Right UA	Absent Left UA	Isolated SUA	SUA + Aneuploidy	SUA + non chromosomal abnormalities
1	77	27%	73%	74%	7.8%	18.2%
2	46	45.7%	54.3%	84%	-	13%
3	10	60%	40%	40%	10%	50%
4	102	30.4%	69.6%	57.8%	9.8%	32.4%
Total	235	33.6%	66.4%	68.1%	7.2%	24.7%
Ref – References. UA – Umbilical artery SUA – Single umbilical artery

REFERENCES

1. Abuhamad AZ, Shaffer W, Mari G, Copel JA, et.al. Single umbilical artery: Does it matter which artery is missing?

Am J Obstet Gynecol 1995;173:728-732.

2. Blaser S, Sujov P, Escholi Z, Itai B et.al. Single umbilical artery – right or left. Does it matter?

Prenat Diagn 1997;17:5-8.

3. Fukada Y, Yasumizi T, Hoshi K. Single umbilical artery: correlation of the prognosis and side of the missing artery.

Int J Obstet Gynecol 1998;61:67-68.

4. Geipel A, Germer U, Welp T, Schwinger E, Gembruch U. Prenatal diagnosis of single umbilical artery: determination

of the absent side, associated anomalies, doppler findings and perinatal outcome.

Ultrasound Obstet Gynecol 2000;15:114-117.

References

1. Leung AKC, Robson WLM. Single umbilical artery. Am J Dis CHILD 1989;143:108-111.
2. Shalev E. Placenta and umbilical cord. In: Chervanek FA, Isaacson GC, Campbell S (eds.) Ultrasound in Obstetrics and Gynecology, pp 1089-1091. Boston: Little, Brown.
3. Nyberg DA. Single umbilical artery: orenatal detection of concurrent abnormalities. J Ultrasound Med 1991;10:247-253.
4. Heifitz SA. Single umbilical artery: a stastical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol 1984;8:345-378.
5. Pageaut G, Opperman A, Carbillet JP. L'absence d'une artere ombilicale (a propos de 57 observations) Rev CHU 1968;13:26.