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Yu J, Wu Q, Kong F, Ning Y. Diagnosis of single umbilical artery and risk of foetal congenital malformations by prenatal ultrasound: a retrospective study. BMC Pregnancy Childbirth 2024; 24:193. [PMID: 38475732 DOI: 10.1186/s12884-024-06375-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Single umbilical artery (SUA) is strongly associated with foetal structural abnormalities; however, the exact pattern of this association has not been described. We aimed to investigate the occurrence of malformations in singleton pregnancies with SUA in China and to study the association between the absent side of the umbilical artery and foetal malformations. METHODS This was a retrospective study of singleton pregnancies for which routine first-trimester anatomical screening was performed at 11+ 0-13+ 6 gestational weeks and, if the pregnancy continued, a second-trimester scan was performed at 20+ 0-24+ 0 weeks. Data were extracted from records at the referral centre, the Obstetrics and Gynecology Hospital of Fudan University, between January 2011 and April 2019 (n = 47,894). Using logistic regression, the odds ratios (OR) with 95% confidence intervals (CIs) were calculated for malformations associated with SUA. RESULTS The incidence of SUA in our study was 2.0% (970/47,894). Of all foetuses with SUA, 387 (39.9%) had structural malformations. The malformation type varied, with cardiovascular complications being the most common. A robust association was observed between SUA and oesophageal stenosis or atresia (OR: 25.33), followed by cardiovascular (OR: 9.98-24.02), scoliosis (OR: 18.62), genitourinary (OR: 2.45-15.66), and brain malformations (OR: 4.73-9.12). The absence of the left umbilical artery (n = 445, 45.9%) was consistent with that of the right umbilical artery (n = 431, 44.4%). Furthermore, a significantly higher rate of an absent right than the left umbilical artery (p<0.01) was observed in SUA with foetal abnormalities than in SUA with no malformations. CONCLUSIONS Overall, we observed a higher risk of various specific malformations in foetuses with SUA, and a strong association between SUA and oesophageal stenosis or atresia. The absence of the right umbilical artery was most common in foetuses with SUA and structural malformations. This study provides a reference for ultrasonographers in conducting foetal structural screening for pregnant women with SUA.
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Affiliation(s)
- Junjin Yu
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qingqin Wu
- Department of Pharmacy, Dongshan Hospital, Linyi, Shandong, China
| | - Fanbin Kong
- Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
| | - Yan Ning
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, No. 128, Shenyang Road, Shanghai, 200082, China.
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Pan S, Xu A, Lu X, Chen B, Chen X, Hua Y. Umbilical artery thrombosis risk factors and perinatal outcomes. BMC Pregnancy Childbirth 2024; 24:137. [PMID: 38355469 PMCID: PMC10865511 DOI: 10.1186/s12884-024-06335-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
PURPOSE The purpose of this study was to investigate the risk factors for umbilical artery thrombosis (UAT) and the relationship between umbilical artery thrombosis and perinatal outcomes. METHODS This was a retrospective study that enrolled singleton pregnant women who were diagnosed with umbilical artery thrombosis. The control group recruited pregnant woman with three umbilical vessels or those with isolated single umbilical artery (iSUA) who were matched with umbilical artery thrombosis group. The risk factors and perinatal outcomes were compared between the groups. RESULTS Preconception BMI (OR [95%CI]: 1.212 [1.038-1.416]), abnormal umbilical cord insertion (OR [95%CI]: 16.695 [1.333-209.177]) and thrombophilia (OR [95%CI]: 15.840 [1.112-223.699]) were statistically significant risk factors for umbilical artery thrombosis. An elongated prothrombin time (OR [95%CI]: 2.069[1.091-3.924]) was strongly associated with the occurrence of UAT. The risks of cesarean delivery, preterm birth, fetal growth restriction, neonatal asphyxia, and intraamniotic infection were higher in pregnancies with UAT than in pregnancies with three umbilical vessels or isolated single umbilical artery (P<0.05). Additionally, the incidence of thrombophilia was higher in pregnant women with umbilical artery thrombosis than those with isolated single umbilical artery (P = 0.032). Abnormal umbilical cord insertion was also found to be associated with an elevated risk of iSUA (OR [95%CI]: 15.043[1.750-129.334]). CONCLUSIONS Abnormal umbilical cord insertion was the risk factor for both umbilical artery thrombosis and isolated single umbilical artery. The pregnancies with umbilical artery thrombosis had a higher risk of the adverse perinatal outcomes.
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Affiliation(s)
- Shuangjia Pan
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Anjian Xu
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xinyue Lu
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Baoyi Chen
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xianjun Chen
- Department of Obstetrics and Gynecology, Taizhou Women and Childrens Hospital of Wenzhou Medical University, Taizhou, 325000, China.
| | - Ying Hua
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
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Zhan J, Jia F, Gao Q, Xiao X. A case report of single umbilical artery combined with fetal bladder exstrophy in singleton pregnancy and related literature review. BMC Pregnancy Childbirth 2024; 24:122. [PMID: 38336714 PMCID: PMC10854176 DOI: 10.1186/s12884-024-06318-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND According to prenatal ultrasonographic studies, single umbilical artery may be present alone or in association with other fetal abnormalities. So far, the exact pathogenesis of bladder exstrophy is unclear. Some scholars believe that bladder exstrophy and cloacal exstrophy should be regarded as a disease spectrum to explore their pathogenesis. If bladder exstrophy and cloacal exstrophy are regarded as the same disease spectrum, then we can speculate that the single umbilical artery should have the probability of being accompanied by bladder exstrophy at the same time. CASE PRESENTATION For the first time, we report a rare case of fetal bladder exstrophy with single umbilical artery in single pregnancy. This patient underwent targeted color Doppler ultrasound at 26 weeks of pregnancy which first suspected bladder exstrophy with single umbilical artery and fetal MRI for diagnosis at 38 + 3 weeks of pregnancy which confirmed the suspicion. After the diagnosis was confirmed, the patient was scheduled for a multidisciplinary discussion. Ultimately the patient opted for induced fetal demise at 38 + 5 weeks of pregnancy and the physical appearance of the fetal demise affirmed previous ultrasound and MRI examination results. CONCLUSIONS Our report is the first finding of single umbilical artery combined with bladder exstrophy in a singleton pregnancy. Accordingly, our case enhances the evidence that cloacal exstrophy and bladder exstrophy should be treated as the same disease spectrum. In addition, we conducted a literature review on the diagnostic progress of single umbilical artery combined with bladder exstrophy, hoping to provide useful references for the diagnosis of this disease.
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Affiliation(s)
- Jun Zhan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20 Ren Min Nan Road, Chengdu, Sichuan, 610041, China
| | - Fenglin Jia
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20 Ren Min Nan Road, Chengdu, Sichuan, 610041, China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Qianqian Gao
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20 Ren Min Nan Road, Chengdu, Sichuan, 610041, China
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xue Xiao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20 Ren Min Nan Road, Chengdu, Sichuan, 610041, China.
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Hyun Lee N, Joung Choi H. Analysis of single umbilical artery with concurrent congenital anomaly: Is it a risk factor for poor prognosis? A cross-sectional study. Int J Reprod Biomed 2024; 22:139-148. [PMID: 38628781 PMCID: PMC11017210 DOI: 10.18502/ijrm.v22i2.15710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/27/2023] [Accepted: 12/25/2023] [Indexed: 04/19/2024] Open
Abstract
Background A single umbilical artery (SUA) may coexist with a single anomaly or multiple congenital anomalies. Although anomalies associated with SUA can primarily cause high perinatal mortality, their clinical significance has not been evaluated. Objective We investigated the relationship between the clinical features and the type or number of concurrent anomalies in neonates with SUA. Materials and Methods In this cross-sectional study, 104 neonates with SUA were enrolled from January 2000 to December 2020 at Dongsan hospital, Daegu, South Korea. Data on the maternal history and the neonates demographic characteristics, clinical course, chromosomal analysis, and congenital anomalies, were collected. Results Among the neonates with SUA included, 77 (74.0%) had one or more congenital anomalies; 66 (63.5%) were cardiac, 20 (19.2%) were genitourinary, 12 (11.5%) were gastrointestinal, 5 (4.8%) were central nervous system, 12 (11.5%) were skeletal, and 5 (4.8%) were facial anomalies. The number of concurrent anomalies ranged from 0-4. Neonates with SUA and concurrent gastrointestinal anomaly had a high incidence of initial positive ventilation, intubation, and inotropic drug use and lower Apgar score at 1 min and 5 min. 7 (6.7%) neonates with SUA died. Low birth weight (odds ratio = 6.16, p = 0.05), maternal multiparity (2.41, p = 0.13), gastrointestinal anomaly (5.06, p = 0.11), and initial cardiac resuscitation (7.77, p = 0.11) were risk factors for mortality in neonates with SUA. Conclusion Neonates with SUA and concurrent gastrointestinal anomaly, low birth weight, maternal multiparity, and initial cardiac resuscitation had poor outcomes.
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Affiliation(s)
- Na Hyun Lee
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Hee Joung Choi
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Republic of Korea
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Rechnagel ASA, Jørgensen FS, Ekelund CK, Zingenberg H, Petersen OB, Pihl K. Risk of adverse pregnancy outcome in isolated single umbilical artery diagnosed at the mid-trimester anomaly scan: a large Danish retrospective cohort study. J Matern Fetal Neonatal Med 2023; 36:2239982. [PMID: 37495362 DOI: 10.1080/14767058.2023.2239982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 11/09/2022] [Accepted: 03/16/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To examine the association of isolated single umbilical artery (iSUA) confirmed at the mid-trimester anomaly scan and adverse pregnancy outcome and congenital malformations with up to 10 years postnatal follow up. METHODS This retrospective cohort study included 116,501 singleton pregnancies consecutively enrolled in first trimester screening for aneuploidies and mid-trimester anomaly scan at three University Hospitals in the Capital Region of Copenhagen, Denmark.Data from the Danish Fetal Medicine Database (2008-2017) were verified by manually scrutinizing pre- and postnatal records. The main outcomes of interest were intrauterine fetal demise (IUFD), small for gestational age (SGA), preterm delivery, cesarean section and unrecognized pre- and postnatal congenital malformations. RESULTS In total, 775 pregnancies with iSUA were identified. Isolated SUA were associated with a significantly increased risk of IUFD (OR 4.16, 95% CI 2.06-8.44), SGA < 3rd centile (aOR 2.41, 95% 1.85-3.14) and SGA < 10th centile (aOR 1.84, 95% CI 1.53-2.21), but not with preterm delivery or cesarean section. The laterality of the missing artery was not associated with SGA. In total, 4.3% of pregnancies with iSUA had unrecognized congenital malformations. 1.5% with iSUA had congenital cardiovascular malformations, which were considered minor. CONCLUSION Isolated SUA is associated with IUFD and SGA, supporting surveillance during third trimester. If, during the mid-trimester scan, the sonographer achieves thorough, extended cardiac views and finds no additional malformation other than SUA, fetal echocardiography seems not to be needed.
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Affiliation(s)
- Anne-Sofie Ahlers Rechnagel
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Finn Stener Jørgensen
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Kvist Ekelund
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Helle Zingenberg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Olav Bjørn Petersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kasper Pihl
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Turos JL, Ladanyi E, Szabó T, Szabó B. Perinatal Prognosis of Pregnancies with Single Umbilical Artery in a Romanian Third-Level Unit. Clin Med Res 2023; 21:192-195. [PMID: 38296637 DOI: 10.3121/cmr.2023.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/11/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024]
Abstract
Objectives: Single umbilical artery (SUA) is considered the most common abnormality of the umbilical artery. The objective of the study was to evaluate the perinatal prognosis of fetuses with SUA and to describe the associated malformations. The significance of the study is represented by examining whether our findings are in correlation with data already described.Methods: We performed a prospective cohort study on singleton pregnancies complicated with SUA. The study population was composed of women with singleton pregnancies who were examined at the Department of Obstetrics and Gynecology of the Târgu Mures County Emergency Clinical Hospital between 2012 and 2021.Results: The incidence of SUA in the study population was 0.48%. C-section was performed in 40 cases with SUA and in 5258 cases with no SUA (RR:1.56, P<0.05.) From the total number of 2249 premature deliveries, 23 newborns were diagnosed with SUA (RR:2.12, P<0.05.) From the total number of 869 deliveries with low birth weight (LBW) newborns, 13 were associated with SUA (RR: 3.12, P<0.05.) There were 206 pregnancies noted with antenatal fetal demise after 24 weeks of gestation, and only 2 of them were with SUA (RR:2.01, P>0.05.) Fetal and neonatal malformations were described in 290 cases, and 28 were associated with SUA (R:21.96, P<0.05.) In 57 of 85 cases (67.05%), we found iSUA, and 28 newborns (32.95%) had minor, major, or other associated pathologies. We found two cases of trisomy 18 and one case with trisomy 13 associated with SUA. Investigating the malformations associated with SUA, the most common were cardiac and great vessels malformations (12), followed by limb malformations (8), urogenital malformations (7), digestive tract malformations (7), central nervous system malformations (4), and in one case we found cleft palate.Conclusions: Perinatal prognosis regarding SUA is significantly poorer than in cases without this pathology. One-third of fetuses with SUA were associated with fetal anomalies. The most common pathologies associated with SUA were cardiovascular, limb, urogenital, and digestive system malformations. Our data are similar to those described in other studies; therefore, we conclude, we can implement the general recommendations in our region regarding counselling patients.
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Affiliation(s)
- János Levente Turos
- UMFST: Universitatea de Medicina Farmacie Stiinte si Tehnologie 'George Emil Palade' din Targu Mures, Targu Mures, Mures, Romania
| | - Emmanuel Ladanyi
- Obstetrics and Gynecology, Emergency County Hospital Targu-Mures: Spitalul Clinic Judetean De Urgenta Targu Mures, Mures, Romania
| | - Tamás Szabó
- UMFST: Universitatea de Medicina Farmacie Stiinte si Tehnologie 'George Emil Palade' din Targu Mures, Targu Mures, Mures, Romania
| | - Béla Szabó
- Obstetrics and Gynecology, UMFST: Universitatea de Medicina Farmacie Stiinte si Tehnologie 'George Emil Palade' din Targu Mures, Mures, Romania
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Vafaei H, Rafeei K, Dalili M, Asadi N, Seirfar N, Akbarzadeh-Jahromi M. Prevalence of single umbilical artery, clinical outcomes and its risk factors: A cross-sectional study. Int J Reprod Biomed 2021; 19:441-448. [PMID: 34278197 PMCID: PMC8261099 DOI: 10.18502/ijrm.v19i5.9253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/12/2020] [Accepted: 10/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background Single umbilical artery (SUA) is found in 0.5–6% of all pregnancies worldwide. Although the association of SUA with some congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial. Objective This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well. Materials and Methods In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetuses, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients' medical records. Results The prevalence of SUA was 3.47% (95% CI: 2.6–4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44–0.98). Conclusion A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard.
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Affiliation(s)
- Homeira Vafaei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Obstetrics and Gynecology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khatoon Rafeei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Obstetrics and Gynecology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Dalili
- Clinical Research Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Nasrin Asadi
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Obstetrics and Gynecology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nosaibe Seirfar
- Pathology Department, Jiroft University of Medical Science, Jiroft, Iran
| | - Mojgan Akbarzadeh-Jahromi
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Pathology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Tonismae T, Kline JH, Choe JJ, Schubert F, Tuuli M, Shanks A. Anatomical Survey Versus Fetal Echocardiograms for Diagnosis of Cardiac Defects with a Single Umbilical Artery Cases: A Retrospective Cohort Study and Diagnostic Meta-analysis. J Ultrasound Med 2021; 40:1031-1036. [PMID: 32885858 DOI: 10.1002/jum.15483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/15/2020] [Accepted: 08/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To determine the utility of fetal echocardiography in diagnosing cardiac defects in fetuses with a single umbilical artery (SUA). METHODS A retrospective cohort study of prenatally diagnosed SUA was conducted over a 10-year period at a single institution. Cardiac anatomy on detailed anatomical survey was compared with fetal echocardiogram for fetuses with prenatally diagnosed SUA. A diagnostic meta-analysis of studies comparing fetal anatomical survey to fetal echocardiogram in fetuses with SUA between 2010 to 2019 was also performed. RESULTS Three hundred and twenty fetuses with SUA were identified, 113 of which had completed both ultrasound and echocardiography. There were 36 cases of cardiac defects on prenatal echocardiogram and all had abnormal anatomical ultrasounds. There were zero cases of abnormal cardiac exams (0%) when the cardiac views on anatomical survey were normal. The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound were 100%, 77%, 73% and 100%, respectively. A summary ROC curve demonstrated a high predictive value of routine anatomic survey for cardiac defects (AUC: 0.99). CONCLUSION Anatomic survey is highly predictive in the detection of cardiac defects in fetuses with SUA. Fetal echocardiogram is unnecessary in SUA when cardiac views are normal on ultrasound.
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Chen YC, Wu WJ, Chang SP, Ma GC, Chen M. Prenatal diagnosis of partial monosomy 21q (21q22.1→qter) associated with intrauterine growth restriction and corpus callosum dysgenesis. Taiwan J Obstet Gynecol 2020; 59:157-161. [PMID: 32039787 DOI: 10.1016/j.tjog.2019.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A prenatal diagnosis of partial monosomy 21q(21q22.1→ qter) in fetus with intrauterine growth restriction and corpus callosum dysgenesis but escaped from the detection by cell free DNA testing was reported. CASE REPORT A 31-year-old, primigravida women, presented with intrauterine growth restriction and corpus callosum dysgenesis at 23 weeks of gestational age by anatomic ultrasound screening. The interphase fluorescence in situ hybridization (FISH) analysis on amniocytes revealed monosomy 21, while the cytogenetic analysis and array comparative genomic hybridization (CGH) with CytoScan gene chip ascertained a 12.35 Mb deletion at 21q22.1q22.3. CONCLUSION Although noninvasive prenatal testing is used extensively and can be applied to certain microdeletion diseases, the application for uncommon deletion disorders such as the present case remains limited. Prenatal examination with detailed ultra-sonography combined with different modalities of invasive prenatal testing can provide a more comprehensive information.
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Affiliation(s)
- Ying-Chung Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
| | - Wan-Ju Wu
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
| | - Shun-Ping Chang
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua, Taiwan
| | - Gwo-Chin Ma
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua, Taiwan; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Ming Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Research, Changhua Christian Hospital, Changhua, Taiwan; Department of Molecular Biotechnology, Da-Yeh University, Changhua, Taiwan.
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Eras N. A Case of Ring Chromosome 18 with Single Umbilical Artery Detected During Prenatal Period. Mol Syndromol 2020; 11:217-222. [PMID: 33224015 DOI: 10.1159/000509646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/08/2020] [Indexed: 11/19/2022] Open
Abstract
Fetuses with a single umbilical artery have a risk of increased chromosomal anomalies and congenital malformations. Ring chromosomes are rare and the phenotypic and clinical characteristics of affected individuals show great variability depending on the quantity of the lost critical genes or gains during the formation of the ring or due to mitotic instability. Ring chromosome 18 [r(18)] is characterized by short stature, craniofacial dysmorphism, mental and motor retardation, autoimmune disorders, extremity anomalies, dermal lesions, structural heart malformations, and kidney abnormalities. In this study, the clinical findings of a female patient who had a single umbilical artery in the prenatal period and was diagnosed as de novo r(18) by molecular karyotype analysis were compared with those in the literature. A detailed ultrasonographic examination of the fetus with a single umbilical artery may enable the detection of additional anomalies and thus the early diagnosis of chromosomal anomalies may be possible with prenatal genetic analysis.
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Affiliation(s)
- Nazan Eras
- Department of Medical Genetics, Faculty of Medicine, Mersin University, Mersin, Turkey
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Li TG, Wang G, Xie F, Yao JM, Yang L, Wang ML, Wang J, Xing L, Nie F. Prenatal diagnosis of single umbilical artery and postpartum outcome. Eur J Obstet Gynecol Reprod Biol 2020; 254:6-10. [PMID: 32898754 DOI: 10.1016/j.ejogrb.2020.08.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/18/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the incidence of the single umbilical artery (SUA) malformation and postpartum outcomes in a retrospective analysis of 781 fetuses. MATERIALS AND METHODS This retrospective analysis included 781 pregnant women carrying singleton fetuses diagnosed with SUA at Gansu Provincial Maternal and Child-care Hospital between 2013 and 2019. Detailed data on maternal and fetal characteristics and postpartum outcomes were obtained. RESULTS In total, 624 (79.9 %) fetuses were diagnosed with isolated SUA and 157 (20.1 %) fetuses had SUA together with other structural and/or chromosome abnormalities. The highest incidence of malformation was found in the urinary system, followed by the cardiovascular system and digestive system. The incidence of SUA was 59.1 % on the right side and 40.9 % on the left side. Fetuses with SUA and other abnormalities tended to have a lower mean birth weight (3061 g vs 3201 g, p < 0.01), but no difference in the rate of preterm delivery was noted. CONCLUSIONS After a diagnosis of SUA, structural observation of the fetus is required. The urinary, cardiovascular and digestive systems should be the focus of observation. If relevant malformations are found, then genetic testing must be performed. With isolated SUA, dynamic monitoring of biological indicators is recommended for lower birth weight, but genetic testing is not recommended.
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Affiliation(s)
- Tian-Gang Li
- Department of Ultrasound Diagnosis, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China; Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Gang Wang
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Fang Xie
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Juan-Min Yao
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Lan Yang
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Meng-Lin Wang
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Jian Wang
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Lin Xing
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China
| | - Fang Nie
- Department of Ultrasound Diagnosis, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China.
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Kurakazu M, Kurakazu M, Murata M, Miyamoto T, Takahashi Y, Hamasaki M, Ohta E, Yotsumoto F, Miyamoto S. A partial supernumerary umbilical vein: a case report. J Med Case Rep 2019; 13:149. [PMID: 31101065 PMCID: PMC6525366 DOI: 10.1186/s13256-019-2094-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Abnormalities in the number of vessels can be found for both the umbilical artery and vein. We sometimes encounter cases of a decreased number of umbilical cord vessels, such as a single umbilical artery. In contrast, there may be an increase from three to four vessels within the umbilical cord. A supernumerary umbilical vein is particularly very rare, and it is generally found in combination with congenital anomalies. We report a case of a partial supernumerary umbilical vein. CASE PRESENTATION The previous pregnancy of a 37-year-old healthy Japanese woman (gravida 2, para 1) had been uncomplicated, and the resulting child was alive and well. Prenatal examination at 36 weeks of gestation revealed the coexistence of a four-vessel part and a normal three-vessel part of the umbilical cord. A healthy female neonate weighing 2726 g was born at 38 weeks of gestation. The umbilical cord measured 40 cm in length; the four-vessel part continued to a distance of 18 cm from the surface of the infant's body, and the remaining umbilical cord comprised three vessels. On histological examination, the fetal side of the umbilical cord had two arteries and two veins, and the placental side had two arteries and one vein. Isolated supernumerary umbilical veins tend to be overlooked. We consider that it is important to evaluate the number of umbilical cord vessels in the second trimester using ultrasound combined with color Doppler in at least three sites: the insertion sites on both the fetal abdomen and placenta, and the free loop of the umbilical cord. CONCLUSIONS Prenatal diagnosis of isolated supernumerary umbilical cord vessels tends to be overlooked. However, supernumerary vessels of the umbilical can be associated with fetal congenital anomalies. The number of vessels within the umbilical cord must be examined because the detection of such abnormalities may lead to the prenatal diagnosis of other congenital anomalies.
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Affiliation(s)
- Mariko Kurakazu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masamitsu Kurakazu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masaharu Murata
- Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Tatsuki Miyamoto
- Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Yoko Takahashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Makoto Hamasaki
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Eiji Ohta
- Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Fusanori Yotsumoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Shingo Miyamoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Contro E, Cataneo I, Morano D, Farina A. Reference charts for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord. Arch Gynecol Obstet 2019; 299:947-51. [PMID: 30730012 DOI: 10.1007/s00404-019-05086-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 02/02/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine reference values for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord and to compare these values with standard umbilical Doppler pulsatility index curves from 23 to 40 gestational weeks. METHODS A retrospective longitudinal cohort study was conducted between January 2014 and December 2017 in a tertiary referral hospital and included 62 pregnant women with isolated single umbilical artery (two-vessel cord) and 174 measurements. Only uncomplicated term pregnancies were included. A reference curve for umbilical Doppler pulsatility index was built up and compared with a standard curve commonly used for fetuses with three-vessel cord. RESULTS Umbilical Doppler pulsatility index values were much lower than expected in cases with two-vessel cord compared to 3-vessel cord: mean of the regression equations was 1.02 ± 0.23 vs. 0.86 ± 0.19, respectively (p value < 0.001). This difference was quite constant across the gestational weeks considered, showing that the slopes of the two regressions were very similar. CONCLUSION Reference curves for umbilical Doppler pulsatility index in two-vessel cord pregnancies were determined. Pulsatility index values were significantly different compared with those commonly used for three-vessel cord. Using lower reference values for umbilical pulsatility index in cases with two-vessel cord may allow a better identification of fetuses affected with intrauterine growth restriction, thus improving fetal surveillance.
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Shah N. Prenatal Diagnosis of Single Umbilical Artery: Incidence, Counselling and Management in Indian Scenario. J Obstet Gynaecol India 2018; 68:437-9. [PMID: 30416268 DOI: 10.1007/s13224-017-1089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 12/29/2017] [Indexed: 10/18/2022] Open
Abstract
Purpose The objective of this study is to report the incidence of single umbilical artery (SUA) on prenatal diagnosis and formulate protocol for counselling and its management in Indian scenario. Method A total of 1024 cases were screened for Single umbilical artery (SUA) between 12 and 20 weeks gestation during the 1 year period from May 2016 to April 2017. Targeted anomaly scan was performed for all cases at 18-20 weeks. Those with additional structural anomalies were subjected to invasive genetic testing. Serial growth monitoring starting from 28 weeks was done. Results Out of ten cases diagnosed with SUA, five had isolated SUA. Two out of five cases of isolated SUA developed FGR in third trimester. Out of the remaining, three cases with additional structural anomalies had normal foetal karyotype, whereas other two cases showed chromosomal abnormalities (12pder and trisomy 18). Conclusion Targeted anomaly scan is must in all cases of SUA. Invasive genetic testing must be offered in case of associated anomalies. Serial growth monitoring in third trimester is an important part of protocol.
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Kim HJ, Kim JH, Chay DB, Park JH, Kim MA. Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis. Obstet Gynecol Sci 2017; 60:266-73. [PMID: 28534012 DOI: 10.5468/ogs.2017.60.3.266] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/21/2016] [Accepted: 10/19/2016] [Indexed: 12/18/2022] Open
Abstract
Objective The aim of this study was to evaluate the association between prenatally diagnosed isolated single umbilical artery (iSUA) and perinatal outcomes. Methods We searched Medline, Embase, the Cochrane Library, and KoreaMed from inception to January 2016, with no language or regional restrictions, for cohort and case-control studies reporting on the relationship of iSUA and perinatal outcomes. We assessed the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission, and perinatal mortality in fetuses with iSUA compared with those in fetuses with three vessel cord. Results Eleven articles totaling 1,731 pregnancies with iSUA met the selection criteria. Studies varied in design, quality, outcome definition, and results. Meta-analysis carried out within predefined groups showed that the presence of an iSUA was associated with small for gestational age (OR, 2.75; 95% CI, 1.97 to 3.83; P<0.00001), preterm birth (OR, 2.10; 95% CI, 1.72 to 2.57; P<0.00001), pregnancy-induced hypertension (OR, 1.62; 95% CI, 1.00 to 2.63; P=0.05), neonatal intensive care unit admission (OR, 2.06; 95% CI, 1.33 to 3.19; P=0.001), and perinatal mortality (OR, 2.29; 95% CI, 1.32 to 3.98; P=0.003). Conclusion Pregnancies complicated by iSUA are at increased risk for small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission and perinatal mortality. Further, large prospective cohort studies are required to improve the quality of prenatal counseling and the neonatal care for pregnancies with iSUA.
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Abstract
AIM Identify structural anomalies and adverse pregnancy outcomes accompanying single umbilical artery (SUA) and persistent right umbilical vein (PRUV) and to investigate whether SUA and PRUV are associated with chromosomal abnormalities and if these defects warrant invasive antenatal diagnosis. METHODS We retrospectively analyzed pregnancies with an antenatal diagnosis of SUA/PRUV from the International Peace Maternity and Child Health Hospital (IPMCHH) database. Data of structural malformations, fetal karyotyping, and pregnancy outcomes were analyzed. RESULTS Results revealed that 13.9 and 7% of SUA and PRUV cases, respectively, had malformations. Furthermore, 60% of the malformations accompanying SUA were isolated congenital heart disease (CHD), and 50% of the malformations accompanying PRUV were multiple malformations including CHD. All primarily diagnosed isolated PRUV (iPRUV) cases and 92.6% of primarily diagnosed iSUA cases had normal fetal echocardiography. Cases of iSUA and iPRUV with indications of invasive antenatal diagnosis showed no chromosomal abnormalities. The emergency cesarean section rate did not differ between the study population and the IPMCHH general population (p = .184). CONCLUSION Patients of SUA and PRUV diagnosed in secondary hospitals should be referred to tertiary medical center for further ultrasonography. SUA and PRUV are not indicators for invasive antenatal diagnosis and selective cesarean section.
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Affiliation(s)
- Lulu Sun
- a Department of Obstetrics and Gynecology , International Peace Maternity and Child Health Hospital of China Welfare Institute , Shanghai , China
| | - Yanlin Wang
- b Department of Prenatal Diagnosis Center , International Peace Maternity and Child Health Hospital of China Welfare Institute , Shanghai , China
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Bhat A, Ilyas M, Dev G. Prenatal sonographic diagnosis of limb-body wall complex: case series of a rare congenital anomaly. Radiol Case Rep 2016; 11:116-20. [PMID: 27257465 PMCID: PMC4878923 DOI: 10.1016/j.radcr.2016.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 02/07/2016] [Indexed: 12/01/2022] Open
Abstract
Three case reports of a rare congenital anomaly “limb-body wall complex” also known as “body stalk syndrome” are presented with prenatal ultrasonographic diagnostic features, immediate after delivery evaluation, and histopathologic analysis.
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Affiliation(s)
- Arshad Bhat
- Department of Radiodiagnosis and Imaging, SMGS Hospital, Govt. Medical College and Associated Hospitals, Jammu, 180001, India
| | - Mohd Ilyas
- Department of Radiodiagnosis and Imaging, Govt. Medical College and Associated Hospitals, Jammu, Lane 22, House No. 38, Tawi Vihar, Sidhra, Jammu, 180001, India
| | - Ghanshyam Dev
- Department of Radiodiagnosis and Imaging, Govt. Medical College and Associated Hospitals, Jammu, Lane 22, House No. 38, Tawi Vihar, Sidhra, Jammu, 180001, India
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Iqbal S, Raiz I. Isolated single umbilical artery in twin pregnancies and its adverse pregnancy outcomes - a case report and review of literature. J Clin Diagn Res 2015; 9:AD01-4. [PMID: 25737967 DOI: 10.7860/jcdr/2015/10669.5439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/01/2014] [Indexed: 11/24/2022]
Abstract
Single umbilical artery is the most common congenital abnormality of the umbilical cord and is seen in 4-11% of twin pregnancies. It is usually associated with intrauterine growth retardation, preterm labour, small-for-dates and other structural anomalies. There is no significant difference in the incidence between monochorionic and dichorionic twins. The left artery is usually absent more commonly than the right. The female co-twin was predominantly more affected than their male counterparts. Single umbilical artery is found twice more common in white women than in Afro-Asians and Americans. The hemodynamic disturbances occur early in the embryonic development, influence greatly in the development of single umbilical artery. Genetic and environmental factors also play a major role in the development of this anomaly. The pregnancies with single umbilical artery were classified as high risk group, because the overall perinatal mortality rate was estimated to be as high as 20%. There is a significant increase in the occurrence of single umbilical artery in pregnancies due to artificial reproductive technologies, as well as in spontaneous miscarriages. Prenatal ultrasonography is the principal diagnostic technique employed to identify single umbilical artery during 3(rd) trimester of pregnancy. The present case, reports the presence of a single umbilical artery in a monozygotic, monochorionic twin pregnancy, which is acardiac-acephalic fetus, small for dates, female sex, associated with other major structural anomalies, and was still born. Authors analyse its incidence, clinical presentations and pregnancy outcome and also review the pertinent literature.
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Affiliation(s)
- Showkathali Iqbal
- Professor, Department of Anatomy, Amala Institute of Medical Sciences , Thrissur, Kerala, India
| | - Iqbal Raiz
- Medical Under Graduate, Government Medical College , Kozhikode, Kerala, India
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Kim J, Park KH, Hwang JM. Ocular findings in children with single umbilical artery: a case series of 14 children. Korean J Ophthalmol 2014; 28:155-8. [PMID: 24688258 PMCID: PMC3958631 DOI: 10.3341/kjo.2014.28.2.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 07/15/2013] [Indexed: 11/23/2022] Open
Abstract
Purpose Single umbilical artery (SUA) is the most common malformation of the umbilical cord. However, there have been no studies on the ocular findings in SUA, except for one case report. This study aimed to investigate the ocular findings in children with SUA. Methods Fourteen children (eight boys and six girls) with SUA were evaluated retrospectively. All children underwent a complete ophthalmologic examination. Results The prevalence of abnormal ocular findings in children was up to 42.9%. Refractive errors are detected in four eyes (14.3%): myopia ≥-1.50 diopters (D) in one eye (3.6%) and hyperopia ≥+2.00 D in three eyes (10.7%). Epiblepharon was found in three children (21.4%), and strabismus was detected in one child (7.1%). Conclusions Approximately half of the children with SUA showed abnormal ocular findings, therefore, our case series highlight the need for a comprehensive ocular examination and larger prospective research studies in young patients with SUA.
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Affiliation(s)
- Jongshin Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyo Hoon Park
- Department of Obsterics & Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Abstract
Umbilical cord abnormalities are known to be associated with congenital anomalies, chromosomal abnormalities and potential complications during pregnancy. We are reporting a case of a multivessel umbilical cord which comprised two umbilical veins alongwith a single umbilical artery.
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Affiliation(s)
- Subrat Panda
- Associate Professor, Department of Obstetrics and Gynaecology, NEIGRIHMS , Shillong, India
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