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Single umbilical artery: what does it mean for the fetus? A case-control analysis of pathologically ascertained cases
Sandra Prucka1, Michele Clemens, Catherine Craven
1Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
Purpose:
To ascertain the frequency of chromosomal and other anomalies in fetuses with single umbilical artery.
Methods:
Placentas with single umbilical artery were identified from hospital pathology laboratory records. For each identified case, the next consecutive placenta with two umbilical arteries served as a control. Pathology records, maternal histories, and prenatal ultrasounds when available were reviewed for congenital anomalies, pregnancy complications, and maternal characteristics. When indicated, placental specimens, amniocytes, or neonatal bloods were karyotyped.
Results:
Single umbilical artery existed in 2.0% (97/4846) of pathological specimens. Fetuses with single umbilical artery had significantly more chromosomal (10.3% vs. 1.0%) and other congenital anomalies (27% vs. 8%).
Conclusions:
The high incidence of major chromosomal and congenital anomalies justifies detailed fetal ultrasonography, echocardiography, and amniocentesis for karyotype when single umbilical artery is discovered during routine ultrasound.
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