SINGLE UMBILICAL ARTERY - CORRELATION OF ULTRASONOGRAPHY AND DOPPLER BLOOD-FLOW ANALYSIS MATH PERINATAL OUTCOME

Objective: The single umbilical artery (SUA) is the most commonly enco untered abnormality of the human umbilical cord in pregnancy, and has been currently associated with adverse perinatal events. The aim of ou r study was to investigate the clinical and prognostic significance of SUA, and the reliability of routine ultrasonography for the identific ation of the number of umbilical vessels and the contribution of Doppl er blood flow evaluation. Methods: During a 27-month period, a total o f 2768 routine ultrasounds were performed. The diagnosis of SUA relied on B-mode imaging. Complementary studies included Doppler blood flow assessment (pulse wave and Color Flow Mapping) and pathologic placenta l examination. Results: The number of umbilical vessels was recorded i n only 32.4% of the cases of routine ultrasound. In a total of 2768 fe tuses, 12 cases of SUA were found. There was a 25% prematurity rate, 6 6.6% concurrent structural abnormalities, 30% chromosomopathies, intra uterine growth retardation in 16.6%, and a mortality rate of 36.3%. Co nclusions: Our data show that SUA was almost systematically related to an adverse perinatal outcome. The identification of the umbilical cor d vessels should be included in routine ultrasonography and can be con firmed by Color Flow Mapping. Doppler blood flow waveform-derived resi stance indexes seem to be devoid of diagnostic and prognostic signific ance.