Prenatal diagnosis of single umbilical by ultrasound: emphasis on the absent side and its relation to associated anomalies

doi:10.3877/cma.j.issn.1672-6448.2016.08.009

Abstract

Abstract:

Objective

To discuss the absent side of a single umbilical artery (SUA) and the clinical significance of the associated anomalies which related to it.

Methods

The characteristics of the Prenatal ultrasound findings and the associated anomalies of 121 SUA fetuses which were all examined prospectively in Prental Ultrasound Center of Suzhou Municipal Hospital from October 2014 to December 2015 were studied and analyzed.

Results

The ultrasonic features of SUA: (1) One hundred and twenty-one fetuses with SUA were diagnosed prenatally by ultrasound. There was only one umbilical artery surrounding the urinary bladder through transverse section by two-dimensional ultrasound. (2) The results of the findings of the left-absent umbilical artery and the right-absent umbilical artery: the left-absent umbilical artery was detected in 59/121 (48.8%, 59/121) fetuses, compared with right-absent umbilical artery in 62/121 (51.2%, 62/121) cases. (3) Associated with congenital anomalies: congenital anomalies were noted prenatally in 16/121 SUA fetuses and the most common abnormality was heart defects. These heart defects include ventricular septal defect, tetralogy of Fallot, persistent left superior vena cave, right-sided aortic arch, aortic dysplasia, enlarged right atrium and ventricle. Congenital anomalies were noted prenatally in 5/59 fetuses with left-absent umbilical artery and in 11/62 fetuses with right-absent umbilical artery.

Conclusions

In SUA fetuses, the absence of umbilical artery appears to occur equally at each side. Moreover, the relevance ratio of the right-absent umbilical artery with congenital anomalies is higher than that of the left-absent umbilical artery with congenital anomalies.

Key words: Ultrasonography, prenatal, Fetus, Single umbilical artery

Weina Zhong, Xuedong Deng, Linliang Yin. Prenatal diagnosis of single umbilical by ultrasound: emphasis on the absent side and its relation to associated anomalies[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(08): 598-602.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.08.009

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References 16

[1]	Heifetz SA. Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature [J]. Perspect Pediatr Pathol, 1984, 8(4): 345-378.
[2]	Leung AK, Robson WL. Single umbilical artery. A report of 159 cases [J]. Am J Dis Child, 1989, 143(1): 108-111.
[3]	Lilja M. Infants with single umbilical artery studied in a national registry. General epidemiological characteristics [J]. Paediatr Perinat Epidemiol, 1991, 5(1): 27-36.
[4]	Jones TB, Sorokin Y, Bhatia R, et al. Single umbilical artery: accurate diagnosis? [J]. Am J Obstet Gynecol, 1993, 169(3): 538-540.
[5]	Gornall AS, Kurinczuk JJ, Konje JC. Antenatal detection of a single umbilical artery: does it matter? [J]. Prenat Diagn, 2003, 23(2): 117-123.
[6]	Prucka S, Clemens M, Craven C, et al. Single umbilical artery: what does it mean for the fetus? A case-control analysis of pathologically ascertainedcases [J]. Genet Med, 2004, 6(1): 54-57.
[7]	Martínez-Payo C, Gaitero A, Tamarit I, et al. Perinatal results following the prenatal ultrasound diagnosis of single umbilical artery [J]. Acta Obstet Gynecol Scand, 2005, 84(11): 1068-1074.
[8]	Persutte WH, Hobbins J. Single umbilical artery: a clinical enigma in modern prenatal diagnosis [J]. Ultrasound Obstet Gynecol, 1995, 6(3): 216-229.
[9]	Abuhamad AZ, Shaffer W, Mari G, et al. Single umbilical artery: does it matter which artery is missing? [J]. Am J Obstet Gynecol, 1995, 173(3 Pt 1): 728-732.
[10]	Geipel A, Germer U, Welp T, et al. Prenatal diagnosis of single umbilical artery: determination of the absent side, associated anomalies, Dopplerfindings and perinatal outcome [J]. Ultrasound Obstet Gynecol, 2000, 15(2):114-117.
[11]	Lubusky M, Dhaifalah I, Prochazka M, et al. Single umbilical artery and its siding in the second trimester of pregnancy: relation to chromosomal defects [J]. Prenat Diagn, 2007, 27(4): 327-331.
[12]	Chow JS, Benson CB, Doubilet PM. Frequency and nature of structural anomalies in fetuses with single umbilical arteries [J]. J Ultrasound Med, 1998, 17(12): 765-768.
[13]	Blazer S, Sujov P, Escholi Z, et al. Single umbilical artery--right or left? does it matter? [J]. Prenat Diagn, 1997, 17(1): 5-8.
[14]	Froehlich LA, Fujikura T. Follow-up of infants with single umbilical artery [J]. Pediatrics, 1973, 52(1): 6-13.
[15]	Sepúlveda WH. Antenatal sonographic detection of single umbilical artery [J]. J Perinat Med, 1991, 19(5): 391-395.
[16]	Persutte WH, Lenke RR. Transverse umbilical arterial diameter: technique for the prenatal diagnosis of single umbilical artery [J]. J Ultrasound Med, 1994, 13(10): 763-766.

单脐动脉缺失侧别	例数	母亲年龄（岁）	胎儿孕龄（周）	伴发其他异常
左侧	5	26~40	18~27	半叶全前脑，唇腭裂，Dandy-Walker变异，左足内翻，双肾积水，室间隔缺损，右位主动脉弓，双上肢发育异常，多囊性肾发育不良，颈项透明层增厚
右侧	11	23~40	18~32	骶尾部椎弓根骨化不全，闭合性脊柱裂，法洛四联症，唇腭裂，VACTERL综合征，主动脉弓发育不良，脑积水，永存左上腔静脉，双胎输血综合征，双上肢异常，鼻骨缺失，腹腔混合性包块，右心房、右心室增大，盆腔马蹄肾

单脐动脉缺失侧别	例数	母亲年龄（岁）	胎儿孕龄（周）	伴发其他异常
左侧	5	26~40	18~27	半叶全前脑，唇腭裂，Dandy-Walker变异，左足内翻，双肾积水，室间隔缺损，右位主动脉弓，双上肢发育异常，多囊性肾发育不良，颈项透明层增厚
右侧	11	23~40	18~32	骶尾部椎弓根骨化不全，闭合性脊柱裂，法洛四联症，唇腭裂，VACTERL综合征，主动脉弓发育不良，脑积水，永存左上腔静脉，双胎输血综合征，双上肢异常，鼻骨缺失，腹腔混合性包块，右心房、右心室增大，盆腔马蹄肾

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