Postnatal development of fetuses with a single umbilical artery: differences between malformed and non-malformed infants
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Postnatal development of fetuses with a single umbilical artery: differences between malformed and non-malformed infantsv Jose Vicente Arcos-Machancoses, Purificación Marín-Reina, Eugenia Romaguera-Salort, Yolanda García-Camuñas, Antonio Pérez-Aytés, Máximo Vento Valencia, Spain
Methods: We reviewed 96 cases of iSUA and nonisolated SUA (niSUA), diagnosed in a period of two years in a referral hospital for high-risk pregnancies. Data on prenatal explorations, including fetal ultrasonography and karyotyping, were obtained. niSUA was diagnosed when no malformations were found prenatally or in postnatal evaluation. Results: Sixty-six newborns (68.8%) had no other anomalies and 30 (31.3%) presented with a variety of malformations including heart diseases, urophaties, digestive, nervous and musculoskeletal disorders, genetic abnormalities and complex malformations. Cardiological and nephrourological abnormalities were found to be the most frequent association with a SUA (both in 23.8% of malformed SUA newborns). Intrauterine growth restriction was not higher in iSUA newborns than in a normal population. Ultrasound allowed optimal prenatal diagnosis in most cases.
Author Affiliations: Department of Pediatrics (Archos-Machancoses JV, García-Camuñas Y); Division of Neonatology (Marín-Reina P, Vento M); Department of Obstetrics & Gynecology (Romaguera-Salort E), Division of Dysmorphology & Reproductive Assessment (Pérez-Aytés A), University & Polytechnic Hospital La Fe, Valencia, Spain Corresponding Author: Máximo Vento, MD, PhD, Division of Neonatology, University & Polytechnic Hospital La Fe, Bulevar Sur s/n, Valencia 46026, Spain (Tel: +34 961245688; Email: [email protected]) doi: 10.1007/s12519-014-0471-3 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2014. All rights reserved.
World J Pediatr, Online First, March 2014 . www.wjpch.com
Conclusions: The prognosis of the fetus with a SUA is determined by the presence of other malformations observed by an expert sonographer. If no other findings are made, only a routine physical examination should be performed in newborns, but no other complementary examinations are required. World J Pediatr March 2014; Online First Key words: cardiovascular abnormalities; congenital abnormalities; fetal growth retardation; prenatal ultrasonography; single umbilical artery
Introduction
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ccording to the Canadian Society of Obstetricians and Gynecologists, umbilical vessels should be assessed as part of the routine ultrasound examination from 16 to 20 weeks of gestation. The presence of a single umbilical cord is considered as a fetal soft marker of congenital abnormalities. If a single umbilical artery (SUA) is found, a detailed examination of fetal anatomy is recommended, including the kidneys and heart, and adequate monitoring of fetal growth. Since SUA is an isolated finding, invasive techniques that are used to rule out fetal chromosomal abnormalities are not recommended.[1] The consensus document of the Spanish Society o
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