Perinatal management and outcome of fetuses with single umbilical artery diagnosed prenatally

Objective: To investigate the perinatal management and outcome of fetuses d iagnosed prenatally with single umbilical artery. Methods: Sixty-one consecutive fetuses with single umbilical artery diagnos ed prenatally by ultrasonography were included. Thorough prenatal ultrasono graphic screening was carried out to detect associated congenital anomalies . Chromosome study by either amniocentesis or cordocentesis was performed f or all 61 of the fetuses with single umbilical artery. Thorough physical ex amination or autopsy was per formed after delivery. Results: All 61 fetuses were confirmed to have single umbilical artery afte r delivery. Ten (16.4%) of the 61 fetuses with single umbilical artery had abnormal karyotypes. In the single umbilical artery group with abnormal kar yotyping, 8 had detectable structural abnormalities, 1 had symmetrical intr auterine growth retardation, and 1 had no apparent congenital anomalies. Fo r the 51 fetuses with normal karyotyping, 28 had abnormal ultrasonographic findings. In 23 fetuses with single umbilical artery without chromosomal or structural anomalies diagnosed in utero, 7 (30.4%) were found to have stru ctural anomalies (3 with congenital heart disease, 3 with congenital renal disease, and 1 with limb deformity) after birth. Conclusion: Prenatal diagnosis of single umbilical artery should be made wi th caution to avoid false positive cases. When single umbilical artery is d iagnosed prenatally, we suggest 1) targeted ultrasonography for detection o f anomalies with cardiovascular, genitorenal, and limb-skeletal systems; 2) chromosome study for those with intrauterine growth retardation or other a ssociated defects; and 3) thorough investigation after birth.