Frequency of Structural Anomalies in Fetuses With Single Umbilical Arteries: A Report of 34 Cases

Yıl 2012, Cilt: 17 Sayı: 2, 89 - 93, 01.04.2012

Remzi Atılgan Abdullah Boztosun Aygen Çelik Mehmet Reşat Özercan

Öz

Objective: The aim of this study was to present perinatal results of cases with single umbilical artery (SUA). Material and Methods: In this study, prenatally diagnosed 34 cases with SUA were evaluated between March 2006 and January 2011. Results: The gestational age at diagnosis varied between 16 and 37 weeks. The mean maternal age was 28.1 years. Ten of the 34 fetuses had additional congenital anomalies. The incidence of SUA was higher in female fetuses than male fetuses. The incidence of major structural anomalies (29%) were found. Major anomaly rate of female was significantly higher than male. Conclusion: Single umbilical artery, can be determined before 24 weeks of gestation. Early prenatal diagnosis and management is important for karyotype analysis and postnatal results. Detailed ultrasound examination should be performed for detection of additional congenital anomalies.

Anahtar Kelimeler

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Tek Umbilikal Arterli Fetuslarda Yapısal Anomalilerin Sıklığı: 34 Olgunun Sonuçları

Öz

Amaç: Bu çalışmanın amacı, tek umbilikal arter ( TUA ) saptanan olguların perinatal sonuçlarını sunmaktır. Gereç ve Yöntem: Bu çalışmaya Mart 2006 ile Ocak 2011 tarihlari arasında TUA saptanan 34 olgu dahil edildi. Bulgular: Onaltı ile 37 gebelik haftaları arasında tanı konuldu. Ortalama maternal yaş 28.1 yıl olarak bulundu. On fetusta ek anomali saptandı. TUA insidansı kız fetuslarda erkek fetuslardan daha yüksek idi. Majör yapısal anomali insidansı % 29 bulundu. Majör anomali insidansı kız fetuslarda erkek fetuslardan daha yüksekti. Sonuç: TUA, gebeliğin 24. haftasından önce tespit edilebilir. Erken prenatal tanı ve yönetim karyotip analizi ve postnatal sonuçlar için önemlidir. Detaylı ultrasonografi incelemesi ilave konjenital anomalilerin tespiti için yapılmalıdır.

Anahtar Kelimeler

Tek umbilikal arter, Prenatal tanı, Ultrasonografi

Kaynakça

• Gornall A S, Kurinczuk J J, Konje J C. Antenatal detection of a single umbilical artery: does it matter? Prenat Diagn 2003; 23: 117-23.
• Hill LM, DiNofrio DM, Guzick D. Sonographic determination of first trimester umbilical cord length. J Clin Ultrasound 1994; 22: 435–8.
• Leug A, Robson W. Single umblical artery. AJDC 1989; 143:108-11.
• Sepulveda W, Dezerega V, Carstens E, Gutierrez J. Fused umbilical arteries: prenatal sonographic diagnosis and clinical significance. J Ultrasound Med 2001; 20: 59-62.
• Blazer S, Sujov P, Escholi Z, Itai BH, Bronshtein M. Single umbilical artery- right or left? does it matter? Prenat Diagn 1997; 17: 5-8.
• Heifetz SA. Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol 1984; 8: 345.
• Benirschke K, BourneGL. The incidence and prognostic implication of congenital absence of one umbilical artery. Am J Obstet Gynecol 1960; 79: 251-4.
• Nyberg DA.,Mahony BS, Luthy D and Kapur R. Single umblical artery: Prenatal detection of concurrent anomalies. J Ultrasound Med 1991; 10: 247-53.
• L Murphy- Kaulbeck, L Dodds, KS Joseph, M Van den Hof. Single umbilical artery risk factors and prgnancy outcomes. Obstet Gynecol 2010; 116: 843-50.
• Dane B, Dane C, Kiray M, Cetin A, Yayla M. Fetuses with single umbilical artery: analysis of 45 cases. Clin Exp Obstet Gynecol 2009; 36: 116-9.
• Bryan EM., Kohler HG, The missing umbilical artery. Arch. Dis Child 1974; 49: 844.
• Naeye RL: Functionally important disorders of the placenta, umbilical cord, and fetal membranes. Hum Pathol 1987; 18:680-91.
• Delbaere I, Goetgeluk S, Derom C, De Bacquer D, De Sutter P, Temmerman M. Umbilical cord anomalies are more frequent in twins after assisted reproduction. Hum Reprod 2007; 22: 2763-7.
• Yuksel A, Kovancı E, Basaran S, Ermis H, Kılıc G. The Prenatal approach to single umbilical artery case. T Klin J Gynecol Obst 1996; 6: 27-31.
• Lilja M. Infants with single umbilical artery studied in a national registry: general epidemiological characteristics. Paediatr Perinat Epidemiol 1991; 5: 27-36.
• Saller DN Jr, Keen CL, Sun CC, Schwartz S. The association of single umbilical artery with cytogenetically abnormal pregnancies. Am J Obstet Gynecol 1990; 163: 922-5
• Khong TY, George K. Chromosomal abnormalities associated with a single umbilical artery. Prenat Diagn 1992; 12: 965-8.
• Rinehart BK, Terrone DA, Taylor CW, Isler CM, Larmon JE, Roberts WE. Single umbilical artery is associated with an increased incidence of structural and chromosomal anomalies and growth restriction. Am J Perinatol 2000; 17: 229-32.
• Thumala MR, Raju TN, Langemberg P. Isolated single artery anomaly and the risk of congenital malformations: a metaanalysis. J Pediatr Surg 1998; 33: 580-5.
• Dagklis T, Defigueiredo D, Staboulidou I, Casagrandi D, Nicolaides KH. Isolated single umbilical artery and fetal karyotype. Ultrasound Obstet Gynecol 2010; 36: 291-5.
• Pavlopoulos PM, Konstantinidou AE, Agapitos E, Christodoulou CN, Davaris P. Association of single umbilical artery with congenital malformations of vascular etiology. Pediatr Dev Pathol 1998; 1: 487-93.
• Scalercio F, Ferraro M, Mastrantonio P, Scalercio A. Single umbilical artery (SUA) and congenital eye abnormalities. 2 case reports. Minerva Pediatr 1998; 50: 141-4.
• Meizner I, Sherizly I, Mashiach R, Shalev J, Kedron D, BenRafael Z. Prenatal sonographic diagnosis of laryngeal atresia in association with single umbilical artery. J Clin Ultrasound 2000; 28: 435-8.
• Clausen I: Umbilical cord anomalies and antenatal fetal deaths. Obstet Gynecol Survey 1989; 44: 841-4.
• Horton AL, Barroilhet L, Wolfe HM. Perinatal outcomes in isolated single umbilical artery. Am J Perinatol 2010; 27: 321-4.
• Burshtein S, Levy A, Holcberg G, Zlotnik A, Sheiner E. Is single umbilical artery an independent risk factor for perinatal mortality ? Arch Gynecol Obstet 2011; 283: 191-4.