Single Umbilical Artery
Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan in Problem-Based Obstetric Ultrasound, 2019
Prenatal diagnosis of a single umbilical artery should prompt careful examination for other abnormalities, and, in particular, fetal echocardiography should be performed, as heart defects are more common. Fetal karyotyping should be considered depending on the presence of fetal abnormalities and prior risk. Serial ultrasound examination to ensure linear fetal growth should be performed in ongoing cases. The pediatric team should be made aware prior to routine post-natal examination, as there is an increased proportion of significant occult renal malformations in asymptomatic infants born with apparently isolated SUA, with a significant proportion affected with vesico-ureteric reflux.
Obstetrics and gynaecology
Dave Maudgil, Anthony Watkinson in The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
There are multiple causes of raised serum AFP, including wrong dates, missed abortion, central nervous system and renal anomalies, and anterior body wall defects. Ascites and pericardial effusions appear earlier than pleural effusions in fetal heart failure. Auto-somal recessive polycystic kidneys are of increased size and echo-genicity on ultrasound (cysts are not visible on ultrasound). Duodenal obstruction demonstrates the double bubble sign; jejunal obstruction demonstrates multiple filled bowel loops. A single umbilical artery is associated with an increased incidence of fetal abnormality (a single umbilical vein is normal).
Clinical anatomy of the newborn
Prem Puri in Newborn Surgery, 2017
The normal umbilical cord contains two thick-walled umbilical arteries and, near the 12 o’clock position, one larger but thin-walled umbilical vein. The presence of a single umbilical artery is associated with an increased risk of other congenital anomalies, particularly renal, vertebral, cardiovascular, and anorectal malformations,15 and an increased risk of prematurity, growth restriction, and perinatal mortality.16,17 However, routine karyotyping and renal sonography in an infant with an isolated single umbilical artery is not generally recommended.16,18
TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins: Two Cases Treated with Fetoscopic Laser Surgery
Published in Fetal and Pediatric Pathology, 2018
Gabriele Tonni, Gianpaolo Grisolia, Paolo Zampriolo, Federico Prefumo, Anna Fichera, Paola Bonasoni, Mathilde Lefebvre, Suonavy Khung-Savatovsky, Fabien Guimiot, Jonathan Rosenblatt, Edward Araujo Júnior
Cord of twin B was 10 cm long, thin (0.12 cm in diameter), hypercoiled, and inserted on the chorial plate side by side with the insertion of twin A cord, suggesting that the umbilical cord of the acardiac mass (twin B) was almost connected directly on the cord of twin A. Vascular anastomoses could not be truly assessed because of the maceration and the small size of the acardiac mass’s umbilical cord vessels. Even if no entanglement of the cords was noticed at gross examination, the umbilical cord of the acardiac mass likely caused a stricture that resulted in the groove and edema on twin A’s cord (Fig. 13). The placental parenchyma was homogeneous with only twin A’s territory. No area of involuted placenta that may have belonged to the acardiac mass was found. These finding, associated with the peculiar cord insertions, confirmed the TRAP sequence. A single umbilical artery was detected at histology for twin B (Fig. 14).
Value of Placental Examination in the Diagnostic Evaluation of Stillbirth
Published in Fetal and Pediatric Pathology, 2022
Sihem Darouich, Aida Masmoudi
Funicular abnormalities, isolated or associated with placental lesions, were observed in 26/147 cases (18%) of our series and mainly corresponded to overcoiling and insertion abnormalities of the UC (velamentous insertion, trifurcation). A proportion of 15% is reported in the literature [9,10]. A single umbilical artery was observed in 3.4% of our cases. Pinar et al., [13] who studied a large series of stillbirths (518 cases) found a single umbilical artery in about 8% of cases. The clinical significance of this abnormality, which is usually associated with polymalformative syndromes, remains uncertain. It does not appear to be associated with an increased risk of IUGR, perinatal death or aneuploidy if it is isolated on prenatal screening [22].
Prenatal diagnosis and outcome of unilateral multicystic kidney
Published in Journal of Obstetrics and Gynaecology, 2021
Gurcan Turkyilmaz, Bilal Cetin, Emircan Erturk, Tugba Sivrikoz, Ibrahim Kalelioglu, Recep Has, Atıl Yuksel, Tayfun Oktar, Orhan Ziylan
An extrarenal anomaly was detected in 20 (13.8%) cases. Seven (4.8%) cases had isolated single umbilical artery (SUA). In 2 (1.3%) cases, left diaphragmatic hernia with SUA was showed. Open spina bifida in 3 (2%), isolated borderline ventriculomegaly in 3 (2%), tetralogy of Fallot in 2 (1.3%), double outlet right ventricle in 1(0.6%) and extremity contractures in 2 (1.3%) cases were identified. Extrarenal anomalies identified in the prenatal period were shown in Table 2.
Related Knowledge Centers
- Amniocentesis
- Birth Defect
- Chorionic Villus Sampling
- Echocardiography
- Placenta
- Trisomy 18
- Umbilical Cord
- Midwife
- Intrauterine Growth Restriction