Single Umbilical Artery: Does Side Matter?

Abstract

Introduction: The aim of this study was to determine if laterality of an absent umbilical artery (AUA) is associated with specific sonographic findings, chromosomal defects or postpartum birth defects. Materials and Methods: In this retrospective cohort study, ultrasound reports and medical records of patients who received an obstetric ultrasound at the University of Iowa Hospitals and Clinics with an identified laterality of the AUA from 1989 to 2007 (n = 405) were reviewed. Rates of sonographic abnormalities between fetuses with a right versus left AUA were compared using Fisher’s exact test. Adjustments for confounding were made using logistic regression modeling. The significance level was set at 0.05. Results: Right AUAs on ultrasound demonstrate higher unadjusted rates of ultrasound abnormalities with a higher percentage of fetuses with >1 additional abnormality (51.1 vs. 37.0%; p = 0.0043). The left AUA group had a significantly higher percentage of isolated AUA (63.0 vs. 48.8%; p = 0.004). In a multivariate analysis, a sonographic right AUA was significantly associated with gastrointestinal (GI) and genitourinary (GU) abnormalities. No other ultrasonographic and umbilical artery Doppler abnormalities, chromosomal defects or postpartum birth defects were significantly associated with a specific laterality of the AUA. Discussion: Our study identified a significant association between a right AUA and concomitant fetal GI and GU abnormalities. Contrary to previous reports, we conclude that laterality of the AUA may prove to be an easily identified early marker of fetal abnormalities.

Morphological Features of the Umbilical Cord Vessels at the Delivery, in Sudanese Neonates

“…Similar finding was noted by Fujikura [25]. (1984), and Santillan et al [26], (2002), but Bourke et al [14], Geipel et al [22], (2000) and Marie et al Heifet [7], (2009) found that the incidence of a SUA is more common in females than in males.…”

Anatomical Variations of the Blood Vascular System in Veterinary Medicine: The Internal Iliac Artery of the Dog - Part Three

“…In human medicine, the anomaly of the UA is well documented and it is called ‘single umbilical artery’. Diagnosis of this anomaly is important to evaluate together with some others congenital malformations (Johnson and Tennenbaum, ; Pomeranz, ; Murphy‐Kaulbeck et al., ; Kondi‐Pafiti et al., ; Santillan et al., ; Tasha et al., ). Even though such anomalies have not been described in veterinary medicine in detail, animal's models have been used to study the presumptive relationship between the presence of single umbilical artery and organ malformations (Merei, ).…”

Impact of isolated single umbilical artery on pregnancy outcome and delivery in full‐term births

“…There are three theories concerning the pathogenesis of an absent umbilical artery: (i) primary agenesis; (ii) secondary atrophy or atresia of the previously normally developed vessel; and (iii) persistence of the original allantoic artery of the body stalk . Since it was first reported, the SUA has attracted special attention from obstetricians because of the high incidence of complications in infants with SUAs, such as multiple malformations or chromosome abnormalities . An isolated SUA (ISUA) occurs with no complications of congenital abnormality in fetal chromosomes or structure; approximately 80% of SUAs are ISUAs.…”

“…1 Since it was first reported, the SUA has attracted special attention from obstetricians because of the high incidence of complications in infants with SUAs, such as multiple malformations or chromosome abnormalities. [2][3][4] An isolated SUA (ISUA) occurs with no complications of congenital abnormality in fetal chromosomes or structure; approximately 80% of SUAs are ISUAs. However, up-to-date studies on SUAs mostly focus on fetal congenital abnormalities or perinatal mortalities; studies on pregnancy outcome and delivery modes for infants with ISUAs are rare, especially in live, full-term births.…”