Prenatally Diagnosed Single Umbilical Artery (SUA) – Retrospective Analysis of 1169 Fetuses

Friebe-Hoffmann, U; Hiltmann, Andreas; Friedl, Thomas W. P.; Látó, Krisztián; Hammer, Rüdiger; Janni, Wolfgang; Kozlowski, P.

doi:10.1055/s-0043-123463

Cited by 31 publications

(43 citation statements)

References 28 publications

(38 reference statements)

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“…In 60 children (5.1%), chromosomal or structural anomalies were detected postpartum. 68 Isolated single umbilical artery was also noted in another study to be an independent predictor of adverse perinatal outcomes in term neonates. In this study, isolated single umbilical artery was noted in 786 (0.3%) of 233,123 deliveries.…”

Section: Possible Confounding Factors Single Umbilical Arterymentioning

confidence: 79%

“…7,67 Friebe-Hoffmann et al detailed a retrospective analysis of 1169 women with singleton pregnancies diagnosed with single umbilical artery. 68 Of the 169 fetuses, 989 (84.6%) were noted to have an isolated single umbilical artery while 180 (15.4%) presented with additional structural and/or chromosomal anomalies. Fetuses with single umbilical artery had lower birth weight (2825 grams versus 3220 grams, P<0.00) and higher rates of preterm delivery before 34 weeks' gestation (13.7% versus 3.8%, P<0.001), and weighed <5th centile (21.6% versus 9.3%, P<0.001).…”

Section: Possible Confounding Factors Single Umbilical Arterymentioning

confidence: 99%

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<p>Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of Nuchal Cord(s)</p>

Sherer¹,

Ward²,

Bennett³

et al. 2020

IJWH

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Umbilical cord accidents preceding labor are uncommon. In contrast, nuchal cords are a very common finding at delivery, with reported incidences of a single nuchal cord of approximately between 20% and 35% of all singleton deliveries at term. Multiple loops occur less frequently, with reported incidence rates inverse to the number of nuchal cords involved. Rare cases of up to 10 loops of nuchal cord have been reported. While true knots of the umbilical cord have been associated with a 4-10-fold increased risk of stillbirth, nuchal cord(s) are most often noted at delivery of non-hypoxic non-acidotic newborns, without any evidence of subsequent adverse neonatal outcome. Prior to ultrasound, nuchal cords were suspected clinically following subtle (spontaneous or evoked) electronic fetal heart rate changes. Prenatal sonographic diagnosis, initially limited to real-time gray-scale ultrasound, currently entails additional sonographic modalities, including color Doppler, power Doppler, and three-dimensional sonography, which have enabled increasingly more accurate prenatal sonographic diagnoses of nuchal cord(s). In contrast to true knots of the umbilical cord (which are often missed at sonography, reflecting the inability to visualize the entire umbilical cord, and hence are often incidental findings at delivery), nuchal cord(s), reflecting their well-defined and sonographically accessible anatomical location (the fetal neck), lend themselves with relative ease to prenatal sonographic diagnosis, with increasingly high sensitivity and specificity rates. While current literature supports that single (and possibly double) nuchal cords are not associated with increased adverse perinatal outcome, emerging literature suggests that cases of ≥3 loops of nuchal cords or in the presence of a coexisting true knot of the umbilicus may be associated with an increased risk of stillbirth or compromised neonatal status at delivery. This commentary will address current perspectives of prenatal sonographic diagnosis and clinical management challenges associated with nuchal cord(s) in singleton pregnancies.

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Section: Possible Confounding Factors Single Umbilical Arterymentioning

confidence: 79%

Section: Possible Confounding Factors Single Umbilical Arterymentioning

confidence: 99%

<p>Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of Nuchal Cord(s)</p>

Sherer¹,

Ward²,

Bennett³

et al. 2020

IJWH

View full text Add to dashboard Cite

show abstract

“…Friebe-Hoffmann et al demonstrated that 5.1% of neonates born with an isolated single umbilical artery had been delivered preterm (15). Others have reported a preterm rate of 11.8% (16).…”

Section: Discussionmentioning

confidence: 99%

Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery

et al. 2019

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Objective: To investigate pregnancy outcomes of small for gestational age (SGA) neonates born with isolated single umbilical artery (iSUA) compared to SGA neonates without iSUA.Study Design: This was a population-based retrospective cohort analysis. The study group was defined as a singleton SGA neonate born with iSUA, while an SGA neonate without iSUA comprised the comparison group. We evaluated adverse perinatal outcomes in all SGA neonates born at the Soroka University Medical Center between the years 1998–2013. Multiple gestations, fetuses with known congenital malformations or chromosomal abnormalities and patients with lack of prenatal care were excluded from the study. Multivariate logistic regression models were constructed to identify independent factors associated with adverse perinatal outcomes.Results: Of 12,915 SGA deliveries, 1.2% (162) were complicated with iSUA. Women in the study group were older with a significantly lower gestational age at delivery compared with the comparison group. Rates of women who conceived after infertility treatments were higher in the study group. Additionally, patients in the study group had significantly higher rates of preterm deliveries, placental abruption, cord prolapse, non-reassuring fetal heart rates and cesarean delivery were noted in the study group. These neonates had a significantly lower birth weight (1988.0 ± 697 vs. 2388.3 ± 481 p < 0.001) and higher rates of low APGAR scores at the first and fifth minutes after birth compared with controls. Perinatal mortality was also found to be significantly higher among SGA neonates complicated with iSUA. Preterm delivery as well as perinatal mortality were found independently associated with iSUA among SGA neonates (aOR 4.01, 95% CI 2.88–5.59, aOR 2.24, 95% CI 1.25–4.01, respectively).Conclusion: SGA pregnancies complicated with iSUA are at higher risk for adverse pregnancy and perinatal outcomes as compared to SGA pregnancies without iSUA.

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“…Die fetale singuläre Nabelschnurarterie tritt mit einer Inzidenz von etwa 0,5 % auf [14,15]. Die retrospektive Analyse von allen Feten mit einer singulären Umbilikalarterie (SUA), die in einer großen pränatalmedizinischen Praxis diagnostiziert wurden, ergab interessante Erkenntnisse [15]: Über einen Zeitraum von 7 Jahren fand sich bei 1169 Schwangeren mit Einlingen eine SUA (▶ Abb. 10).…”

Section: Häufige Anomalie Fetaler Umbilkalgefäße: Singuläre Umbilikalunclassified

Nabelvenenkatheter in der neonatologischen Notfall- und Intensivbehandlung

Hoppen¹,

Paulun²

2020

Intensivmedizin up2date

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Prenatally Diagnosed Single Umbilical Artery (SUA) – Retrospective Analysis of 1169 Fetuses

Abstract: Once fetal SUA is diagnosed, intense sonoanatomy of the fetus is required and, if associated malformations are found, genetic testing must be offered. In iSUA intermittent biometry is recommended for the early detection of IUGR but additional genetic testing is not necessarily recommended.

Cited by 31 publications

References 28 publications

<p>Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of Nuchal Cord(s)</p>

<p>Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of Nuchal Cord(s)</p>

Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery

Nabelvenenkatheter in der neonatologischen Notfall- und Intensivbehandlung

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