Single umbilical artery and pregnancy outcome: Cause for concern

Abstract

Objective: To study the pregnancy outcome of antenatal women diagnosed with single umbilical artery (SUA) in singleton pregnancy in tertiary medical center and its association with intrauterine growth restriction (IUGR), renal and cardiac anomalies. Materials and methods: We performed a prospective study of 6,711 singleton pregnancies at Sri Ramachandra Medical College, Chennai, between July 2009 and June 2011 and the pregnancies diagnosed with SUA were followed. The primary outcomes were renal anomalies, cardiac anomalies and IUGR. Results: Of the 6,711 pregnancies there were 59 (0.88%) cases of SUA diagnosed at anatomic survey. Thirty seven pregnancies had isolated SUA (62.7%) and 22 singleton pregnancies had associated malformations (37.2%). Conclusion: Our data suggests that the prevalence of SUA and associated anomalies seems to be similar to that reported in other countries. Evaluating cord vessels is important and fetuses with isolated SUA need more detailed assessment and monitoring1 including Doppler study in the presence of IUGR. SUA with multiple anomalies need further evalution with fetal echocardiogram and invasive tests like amniocentesis for karyotyping.