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Objectives A systematic review and meta-analysis was conducted to quantitatively synthesize the current evidence on the association of prenatally diagnosed isolated single umbilical artery (iSUA) in singleton pregnancies with small for gestational age (SGA) neonates and other perinatal outcomes. Methods A search of PubMed/Medline, Scopus and The Cochrane Library was conducted, from inception to February 2021, in order to identify studies comparing the risk of SGA and other perinatal adverse outcomes in prenatally diagnosed iSUA singleton pregnancies vs. those with a 3-vessel cord (3VC). The quality of eligible studies was assessed according to the improved Newcastle–Ottawa Scale (NOS). The heterogeneity of results across the studies was tested using the I2 test. Funnel plots and Egger’s test were used to assess the possibility of publication bias. Prospero RN: CRD42020182586. Results The electronic search identified 7,605 studies, of which 11 were selected, including three retrospective cohort and eight retrospective case control studies, overall reporting on 1,533 iSUA cases. The risk of delivering SGA neonates was increased in cases with iSUA (OR: 2.90; 95% CI: 2.02–4.18; p<0.00001; I2=71%). Similarly, iSUA was associated with an increased risk of pregnancy-induced hypertension (PIH) (OR: 2.23; 95% CI: 1.41–3.54; p<0.000; I2=1%), intrauterine death (IUD) (OR: 2.62; 95% CI: 1.43–4.79; p=0.002; I2=0%), preterm birth (PTB) (OR: 2.48; 95% CI: 1.73–3.56; p<0.00001; I2=56%), cesarean section (CS) (OR: 1.64; 95% CI: 1.11–2.41; p=0.01; I2=78%) and admission to neonatal intensive care unit (NICU) (OR: 2.28; 95% CI: 1.52–3.44; p<0.000001; I2=73%). Conclusions In prenatally diagnosed iSUA there is a higher risk of SGA, PIH, IUD, PTB, CS and NICU admission. These findings support the value of prenatal diagnosis of iSUA, which may subsequently intensify surveillance for the detection of specific pregnancy complications.

The combined effect of brining time, citric acid, oregano oil and pasteurization temperature on the microbiological stability, pH, lipid oxidation (thiobarbituric acid reactive substance [TBARS]), total volatile basic nitrogen (TVBN) and sensory characteristics of trout fillets was evaluated. Sixteen treatment combinations were produced, packaged under modified atmosphere conditions and were studied for a period of 150 days. The total viable counts, phychrophiles, sulfite‐reducing clostridia and lactic acid bacteria populations were present in very low numbers throughout the storage period. The addition of citric acid resulted in lower pH and TBARS values. Oregano oil had a strong antioxidant effect. Pasteurization temperatures of 95C resulted in higher TVBN numbers at the end of the storage period, compared with pasteurization temperatures of 85C. Brining times of 4 h improved the flavor of the trout fillets compared with 1‐h brining, whereas oregano oil improved the flavor only for the fillets brined for 1 h. Practical Applications This paper describes an application of combined hurdles (citric acid, oregano oil, brining and pasteurization) in order to produce ready‐to‐eat trout fillets, otherwise sensitive to microbial spoilage and lipid oxidation, with improved chemical and microbiological stability during storage. Also, it intends to highlight interactions among the combined hurdles as concern product quality. Additionally, although high pasteurization (95C) had a high bacteriocidal impact on the product, it deteriorated texture and led to increased total volatile basic nitrogen numbers. Overall, 4‐h brining combined with 0.1% citric acid, a mild heating process (85C) and a lower than 0.5% addition of oregano oil is considered the best combination for high sensorial characteristics and keeping quality. An interesting finding was the absence of detectable microflora in samples judged as unacceptable, which lead to the conclusion that enzymatic spoilage took place due to endogenous enzymes or microbial enzymes produced prior to pasteurization and processing, which is worth further investigating.

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