ULTRASONOGRAPHIC DETECTION OF SINGLE UMBILICAL ARTERY - A SIMPLE MARKER OF FETAL ANOMALY

Objective: To detect associated anomalies, karyotypes and perinatal pr ognosis of fetuses with single umbilical artery. Method: Fifteen fetus es who have single umbilical artery were evaluated in the obstetrical ultrasonography and medical genetics departments of Osmangazi Universi ty. Results: Fifteen fetuses with single umbilical artery were detecte d during antenatal ultrasonographic examinations. Associated sonograph ic abnormalities include oligohydramnios (two), intrauterine growth re tardation (one), renal agenesis (one), fetal ascites (one), diaphragma tic hernia (one), hydrocephalus (two), and meningomyelocele (one). Com plications related to the pregnancy were pre-eclampsia in one case and abruptio placenta in another. Karyotype analysis was available in 11 cases and the only cytogenetic abnormality detected was trisomy 18 in one case. Two cases with hydrocephalus and single umbilical artery wer e delivered by cesarean section at 34 and 38 weeks, but both died (on the first and fifth days after birth). Five pregnancies were terminate d because of intrauterine death (one), severe pre-eclampsia (one), cyt ogenetic abnormality (one), and multiple congenital anomalies associat ed with single umbilical artery (two) at 36, 27, 22, 26 and 29 weeks, respectively. Eight of the neonates who had no additional congenital o r cytogenetic abnormality were completely normal at birth and during t he neonatal period. Diagnoses were confirmed pathologically in all cas es. Conclusion: Scanning the umbilical cord should be one of the essen tial parts of ultrasonographic examination. When single umbilical arte ry is detected, a detailed ultrasonographic examination is necessary t o rule out associated abnormalities. We advise fetal karyotyping even when no additional pathology can be detected on ultrasonographic exami nation. (C) 1997 International Federation of Gynecology and Obstetrics .