Single Umbilical Artery Risk Factors and Pregnancy Outcomes

Murphy-Kaulbeck, Lynn; Dodds, Linda; Joseph, K. S.; Hof, Michiel Van den

doi:10.1097/aog.0b013e3181f0bc08

Cited by 119 publications

(142 citation statements)

References 34 publications

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“…[11][12][13][14][15] Neonates with isolated single umbilical artery have increased rates of growth restriction (10.9% compared with 25.0%) and estimated fetal weight less than the 10th percentile (odds ratio 2.23; 95% confidence interval [CI] 1.84-2.69). 16 In our institution, we recommend a fetal growth ultrasound examination at 32 weeks of gestation or pregnancies complicated with single umbilical artery. If the follow-up growth ultrasound scan is normal, with an estimated fetal weight more than the 10th percentile, we resume routine prenatal care.…”

Section: Ultrasound Findingsmentioning

confidence: 99%

A Practical Approach to Fetal Growth Restriction

Copel

Bahtiyar

2014

Obstetrics &Amp; Gynecology

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Fetal growth restriction is one of the most complex problems encountered by obstetricians. Ultrasound-estimated fetal weight less than the 10th percentile for the gestational age is the most widely accepted diagnostic criterion. Management protocols vary from institution to institution. Doppler velocimetry provides valuable information about fetal status. We offer a practical approach to management and timing of delivery based on available data in the literature.

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Section: Ultrasound Findingsmentioning

confidence: 99%

A Practical Approach to Fetal Growth Restriction

Copel

Bahtiyar

2014

Obstetrics &Amp; Gynecology

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“…Based on these findings, some authors have recommended that fetal growth should be monitored throughout pregnancy after prenatal diagnosis of a single umbilical artery. [7][8][9]11,12 As a matter of fact, throughout the study period, our management protocol for pregnancies diagnosed with ISUA included serial follow up fetal growth scans. And when fetal growth restriction was diagnosed additional fetal well being tests were performed.…”

Section: Discussionmentioning

confidence: 99%

“…6,7,11,[13][14][15]18,[20][21][22][23] On the other hand, all post-natal studies have shown that birth weight is significantly lower in ISUA pregnancies compared to control pregnancies. 5,9,10,12 This is possibly related to the fact that these are the studies with greater sample size. Moreover, since ISUA was not diagnosed …”

Section: Introductionmentioning

confidence: 99%

“…Compensatory mechanisms allow increase in blood flow through the single artery in order to meet the demands of fetal growth and development throughout pregnancy. 3 Although several studies have reported diminished fetal growth in these pregnancies, [4][5][6][7][8][9][10][11][12] others have not shown differences. [13][14][15] These contradictory findings may be attributed to diverse methodological differences in the published literature.…”

Section: Introductionmentioning

confidence: 99%

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Should fetal growth be a matter of concern in isolated single umbilical artery?

Caldas¹,

Liao²,

Carvalho³

et al. 2014

Rev. Assoc. Med. Bras.

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Should fetal growth be a matter of concern in iSolated Single umbilical artery? rev aSSoc med braS 2014; 60(2):125-130 125original articleShould fetal growth be a matter of concern in isolated single umbilical artery? Conflict of interest: noneObjective: To examine birth weight in pregnancies with isolated single umbilical artery (ISUA). Methods: Case control study with retrospective review of 131 singleton pregnancies with isolated single umbilical artery diagnosed before birth. Control group consisted of 730 singleton pregnancies recruited prospectively, that had histological confirmation of a 3 vessels cord. Pregnancies were classified as uncomplicated or high-risk according to the presence of diseases that increase the risk of placental insufficiency during pregnancy. Mean birth weight and frequency of low birth weight (< 2.500 g), very low birth weight (< 1.500 g) and fetal growth restriction below the 5 th and 10 th centiles were compared between groups. Results: Mean birth weight difference between ISUA (n=131, 2840±701g) and control (n=730, 2.983 ± 671g) pregnancies was 143g (95% CI= 17-269; p=0.04) and birth weight below the 5 th centile was significantly more common in ISUA group [28/131 (21.4%) versus 99/730 (13.6%), p=0.02]. When only uncomplicated pregnancies were considered in both groups, no birth weight differences were observed. Amongst high-risk subgroups, birth weight below the 5 th centile remained significantly more common in ISUA compared to control pregnancies [10/35 (28.6%) versus 53/377 (14.1%), p=0.04]. Conclusion: Isolated single umbilical artery does not increase the risk of fetal growth restriction in uncomplicated singleton pregnancies.

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“…A two-vessel umbilical cord or single umbilical artery is seen in approximately 0.5%-1% of all deliveries, and it is the most common anomaly of the umbilical cord (1). Many risk factors have been suggested in previous studies, including maternal age, maternal smoking status, ethnicity, multiparity, and multiple gestations (2). Some studies have also indicated that risks of some adverse pregnancy outcomes such as intrauterine growth restriction, low birth weight, preterm delivery, and hypertensive disorders in pregnancy could be increased in cases with a single umbilical artery (3,4).…”

Section: Introductionmentioning

confidence: 99%

Determination of risk factors and perinatal outcomes of singleton pregnancies complicated by isolated single umbilical artery in Turkish population

Tülek

Kahraman

Taşkın

et al. 2015

J Turkish German Gynecol Assoc

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Objective:To address the possible risk factors, eventual pregnancy outcomes, and probable troubles in follow-ups of pregnancies complicated by an isolated single umbilical artery and to provide data on Turkish cases in such an aspect that ethnic divergences may have influence. Material and Methods:A total of 16568 singleton pregnancies that were delivered between May 2006 and May 2013 were retrospectively screened. Ninety-three fetuses were found to have an isolated single umbilical artery. One-hundred pregnancies that did not show any structural or chromosomal abnormalities were randomly selected from the rest of the cases to establish the control group. IBM SPSS Statistics 20.0 software was utilized for statistical analysis. Non-parametric data were analyzed with Mann-Whitney U test and were presented as means±standard deviations. P values less than 0.05 were statistically significant. For the adjustment of confounding factors, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multiple logistic regression analysis. Results:The incidence of small for gestational age (SGA) fetuses and hypertensive disorders in pregnancy was found to be significantly higher in cases with an isolated single umbilical artery (p<0.001 and p=0.022, respectively). Maternal smoking was found to be independently associated with the occurrence of an isolated single umbilical artery (OR: 3.556; 95% CI: 1.104-11.45). The risk of preterm birth was not higher in the study group (OR: 0.538; 95% CI: 0.576-2.873). The incidence of cases who underwent cesarean delivery because of non-reassuring fetal heart trace was similar in the study and control groups (p=0.499). Conclusion:Attention should be paid to the development of hypertensive disorders in cases with a diagnosis of an isolated single umbilical artery, and parents should be counseled properly, including the information on increased risk of SGA. Strict follow-up of pregnancies complicated with an isolated single umbilical artery in terms of preterm birth seems unfeasible except in cases with accompanying risk factors for preterm labor. (J Turk Ger Gynecol Assoc 2015; 16: 21-4) Keywords: Isolated single umbilical artery, SGA, pregnancy outcome, hypertensive disorders, preterm birth Received: 06 January, 2014 Accepted: 07 January, 2015 Determination of risk factors and perinatal outcomes of singleton pregnancies complicated by isolated single umbilical artery in Turkish population

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Single Umbilical Artery Risk Factors and Pregnancy Outcomes

Abstract: II.

Cited by 119 publications

References 34 publications

A Practical Approach to Fetal Growth Restriction

A Practical Approach to Fetal Growth Restriction

Should fetal growth be a matter of concern in isolated single umbilical artery?

Determination of risk factors and perinatal outcomes of singleton pregnancies complicated by isolated single umbilical artery in Turkish population

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