Single umbilical artery in twin pregnancies

Klatt, J.; Kühn, Annette; Baumann, Marc; Raio, Luigi

doi:10.1002/uog.9085

Cited by 23 publications

(22 citation statements)

References 20 publications

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Section: Resultscontrasting

confidence: 85%

“…In our large cohort of consecutive twin pregnancies, we found a 1.7% incidence of isolated SUA, significantly less than the recently published literature reporting an incidence of SUA in twins of 4-10%. 6,9 The vast difference from previously reported incidence of 4-10% may be due to specific accrual or referral biases in those cohorts, artificially inflating the incidence. Given the incidence of SUA in singletons is approximately 0.5-1%, 1,2,4 a 1.7% rate of SUA noted in this cohort of twin pregnancies is consistent with what would be expected, approximately double the opportunity for abnormalities in umbilical cord structure to occur in twin pregnancies.…”

Section: Resultsmentioning

confidence: 88%

“…1 Two recent publications reported incidences of SUA in twin gestations of 4.6% and 9.8%, significantly higher than the typically reported incidence of 1% in singleton pregnancies. 2,6 Given that twin pregnancies are already at increased risk for growth abnormalities relative to singletons, and recent studies suggest a high incidence of SUA in twins, we aimed to confirm the incidence of SUA in a large cohort of twin gestations. In addition, we aimed to evaluate whether twin gestations with SUA are at risk for adverse obstetric outcomes compared with those with normal umbilical cord anatomy.…”

Section: Introductionmentioning

confidence: 99%

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The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes

et al. 2013

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Objectives To estimate the incidence of single umbilical artery (SUA) in twin pregnancies and to investigate whether SUA in twin gestations is associated with adverse obstetric outcomes. Methods Retrospective cohort study of consecutive twin pregnancies over 17 years at a tertiary care hospital. Primary exposure was SUA in one or both twins documented at routine second trimester anatomic survey. Adverse obstetric outcomes included small for gestational age (SGA), placental abruption, and preterm birth, evaluated in univariable and multivariable analyses. Analysis was performed both at the pregnancy level and at the fetal level using paired analyses to account for the non-independence of twin pairs. Results Of 2,378 twin pregnancies without major anatomic abnormalities, 1.7% (n=40) had SUA. Only 1 pregnancy (one monochorionic twin pair) was complicated by both twins having SUA. Twin fetuses with SUA are at increased risk for SGA (aOR 2.1 (1.2-4.1), p=0.03) after adjusting for pertinent confounding factors, similar to the findings of previous studies in singleton pregnancies. In addition, twins with SUA may be at increased risk for preterm delivery before 28 weeks compared to twin pregnancies with normal three-vessel umbilical cords (aOR 3.2 (1.3-7.89.4), p=0.01). Conclusions The incidence of SUA in twin gestations in this cohort is significantly less than recently published data. Similar to reports in singleton gestations, SUA appears to be associated with an increased risk for SGA in twins.

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Section: Resultscontrasting

confidence: 85%

Section: Resultsmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes

et al. 2013

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“…27,28 A single umbilical artery, which is also associated with decreased growth, is three times more common in twin than in singleton gestations. 29 Serial ultrasonography examinations every 4-6 weeks are recommended to assess fetal growth, size concordance, and amniotic fluid volume. 18 Growth discordance is calculated by the difference in the estimated twin weights divided by the weight of the larger twin, and is expressed as a percentage.…”

Section: Diamniotic/dichorionic Twinsmentioning

confidence: 99%

Role of ultrasonography in the management of twin gestation

Smith

Treadwell

Berman

2018

Intl J Gynecology & Obste

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Twins represent 1%-2% of all pregnancies, yet continue to account for a disproportionate share of neonatal adverse events including neonatal intensive care admission, morbidity, and mortality. Ultrasonography is central to the proper diagnosis of the type of twinning. Ideally, ultrasonography is performed before 14 weeks of gestation to determine chorionicity and amnionicity. Correct identification of the chorionicity in a twin pregnancy facilitates proper counseling and management of the gestation, including ultrasonography follow-up. Herein, the different types of twinning are reviewed, together with the implications for ultrasonography monitoring of each specific type of twin gestation.

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“…Although developmental origins are not certain, the most widely accepted explanations are atrophy of a previously normal artery, agenesis of one umbilical artery, or persistence of the original embryonic allantoic artery . Single umbilical artery occurs in approximately 0.3% to 1% of pregnancies, with incidence up to 10% in multiple gestations . In 65% to 80% of cases it is an isolated finding .…”

Section: Common Abnormalities Detected On Second Trimester Fetal Ultrmentioning

confidence: 99%

Incidental Fetal Ultrasound Findings: Interpretation and Management

Kaplan¹,

Adams²

2018

J Midwife Womens Health

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Ultrasonography is a common component of prenatal care worldwide and is often used in early pregnancy to determine gestational age, number of fetuses, fetal cardiac activity, and placental location. Patients and their families may also consider ultrasonography a social event, as it provides confirmation and reassurance of a normal pregnancy. Ultrasound screening is typically scheduled in the second trimester to visualize fetal anatomy and confirm gestational age. Most ultrasound examinations are reassuring, but some incidentally identify structural anomalies and soft markers for aneuploidy, making it necessary for health care providers to correctly interpret these findings. The health care provider's ability to prepare patients prior to the ultrasound and deliver the necessary information needed to make informed decisions regarding any follow-up screening or diagnostic testing is critical to reducing parental anxiety. Preparation for the anatomic survey should include counseling for normal and abnormal findings. The ethical concepts of patient autonomy and shared decision making are used as a guide in providing this critical information and enabling informed choices during follow-up for incidental ultrasound findings.

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Single umbilical artery in twin pregnancies

Abstract: Objective Our purpose was to evaluate the antenatal incidence of single umbilical artery (SUA)

Cited by 23 publications

References 20 publications

The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes

The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes

Role of ultrasonography in the management of twin gestation

Incidental Fetal Ultrasound Findings: Interpretation and Management

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