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Single umbilical artery: accurate diagnosis?

T B Jones¹, Y Sorokin, R Bhatia

¹Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201.

American Journal of Obstetrics and Gynecology

|September 1, 1993

Summary

Diagnosing a single umbilical artery (SUA) is often missed, with ultrasound showing low accuracy. Postnatal clinical examination is crucial for identifying neonates with SUA and associated risks.

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Area of Science:

Perinatal Medicine
Diagnostic Accuracy
Neonatal Outcomes

Background:

A single umbilical artery (SUA) is a common umbilical cord anomaly.
SUA is associated with an increased risk of congenital malformations and adverse neonatal outcomes.

Purpose of the Study:

To evaluate the diagnostic accuracy of ultrasonography, obstetricians, and pediatricians in identifying SUA.
To compare the outcomes of neonates with SUA to those with normal umbilical cords.

Main Methods:

A retrospective study of 17,777 singleton births.
Confirmation of SUA by clinical or pathological assessment in 37 cases.
Comparison of neonatal outcomes between SUA and normal cord groups.

Main Results:

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Ultrasonographic diagnosis of SUA had 65% sensitivity and positive predictive value.
24% of cases were missed by obstetricians and 16% by pediatricians.
Neonates with SUA had lower birth weight, earlier delivery, and lower Apgar scores.

Conclusions:

Clinical examination of the umbilical cord is essential for diagnosing SUA.
Improved diagnostic efforts can identify neonates at risk for associated malformations.
Emphasis on postnatal cord assessment is needed to mitigate risks associated with SUA.