Journal of Ultrasound in Medicine, Vol 10, Issue 5 247-253, Copyright © 1991 by American Institute of Ultrasound in Medicine
Single umbilical artery. Prenatal detection of concurrent anomalies
D. A. Nyberg, B. S. Mahony, D. Luthy and R. Kapur
Department of Ultrasound, Swedish Hospital Medical Center, Seattle, WA.
Prenatal sonographic findings were reviewed in 30 fetuses with a single
umbilical artery (SUA) to determine the reliability of ultrasound for
detecting concurrent anomalies. Additional anomalies were identified in 15
fetuses, including 3 fetuses with minor anomalies and 12 fetuses with major
or multiple concurrent anomalies. Minor anomalies observed in 3 fetuses
included 1 case each of pelvic kidney, unilateral absent kidney, and mild
cerebral ventricular dilatation. Major abnormalities detected in 12 fetuses
involved a variety of organ systems and included cardiac defects,
holoprosencephaly, skeletal dysplasia, hydrocephalus, omphalocele,
hydrothorax, enlarged cisterna magna, and diaphragmatic hernia. Clinical
and pathologic correlation showed that all fetuses were correctly
categorized regarding the presence of other anomalies; none of the 15
fetuses in whom an SUA was considered an isolated finding had a significant
anomaly at birth. Chromosome abnormalities were found in 6 of 12 fetuses
with major abnormalities but in none of the 18 remaining fetuses. We
conclude that prenatal ultrasound can reliably identify major concurrent
anomalies in fetuses with SUA. In the absence of additional anomalies,
prenatal detection of SUA should not alter obstetric management.
