UMBILICAL ARTERY DOPPLER VELOCIMETRY IN FETUSES WITH A SINGLE UMBILICAL ARTERY

Objective: Doppler waveform analysis of the umbilical artery is an imp ortant tool for the evaluation of high-risk pregnancies. Yet, availabl e data are based on normal values from three-vessel umbilical cords. O ur purpose was to evaluate the value of umbilical artery Doppler veloc imetry in fetuses with a single umbilical artery. Methods: One hundred thirteen consecutive singleton fetuses with a single umbilical artery between 16 and 40 weeks' gestational age were studied prospectively a t a tertiary referral center for prenatal diagnosis and therapy. Compl ete follow-up was obtained from 103 eases. Results: The systolic-diast olic ratio in the umbilical artery was abnormal in 31 fetuses (30%) an d normal in 72 fetuses (70%). Fetuses with abnormal Doppler waveform a nalysis in the umbilical artery were significantly mole likely to be g rowth restricted (55 compared with 15%), to have complex malformations (58 compared with 1%) or an abnormal karyotype (29 compared with 0%), or not to survive the fetal/perinatal period (42 compared with 0%) th an those with normal Doppler waveform analysis. Conclusion: Fetuses wi th a single umbilical artery and abnormal umbilical Doppler velocimetr y had a significantly increased risk of adverse fetal and neonatal out come compared with those with a single umbilical artery but normal Dop pler studies. ((C) 1997 by The American College of Obstetricians and G ynecologists.)