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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (5): 1200-1205    DOI: 10.31083/j.ceog4805191
Original Research Previous articles | Next articles
Single umbilical artery: a continuous dilemma and challenge in obstetric management
Oana Sorina Tica1, 2, Andrei Adrian Tica2, 3, *(), Doriana Cojocaru4, 5, Irina Tica6, 7, *(), Victor Cojocaru4, 5, Vlad Iustin Tica7, 8, 9
1Department of ''Mother and Child'', University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2Emergency Clinical County Hospital of Craiova, 200642 Craiova, Romania
3Department of Pharmacology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
4Department of Anesthesiology and Intensive Care, ''Nicolae Testemitanu'' State University of Medicine and Pharmacy Chisinau, 2004 Chisinau, Moldova
5''Timofei Mosneaga'' Republican Clinical Hospital Chisinau, 2025 Chisinau, Moldova
6Department of Internal Medicine, Faculty of Medicine, University ''Ovidius'' Constanta, 900527 Constanta, Romania
7University Regional Emergency Hospital of Constanta, 900675 Constanta, Romania
8Department of Obstetrics and Gynecology, Faculty of Medicine, University ''Ovidius'' Constanta, 900527 Constanta, Romania
9Academy of Romanian Scientists, 050045 Bucharest, Romania
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Abstract  
Background: The single umbilical artery (SUA), an entity with almost unknown etiology, is still subject to discussion regarding its clinical significance, especially when it is an isolated discovery (iSUA). Methods: This retrospective study focused on the evaluation of fetuses with ultrasound proven SUA during second trimester screening. These fetuses were carefully investigated for other malformations. The respective pregnancies were attentively followed up and the newborns were evaluated confirming SUA. Results: The incidence of SUA was 0.57%, with 34.6% of these fetuses having associated abnormalities being 19.2% cardiovascular, 15.3% gastrointestinal, 11.5% cerebral, 7.6% osteomuscular and 3.8% urogenital. Aneuploidy was present in 8% of these infants. These rates were significantly greater compared with those noticed in ''normal'' three vessels umbilical cord (TVC) fetuses (control group) (p < 0.001). Similar relations were found for the rates of IUGR and/or SGA, polyhydramnios and oligohydramnios (p < 0.001). Interestingly, in iSUA group (65.4% of all SUA cases), only the rate of oligohydramnios was significantly increased compared with the control group (p = 0.038). Furthermore, in a dichorionic diamniotic twin pregnancy, with only one fetus revealing iSUA, the ''affected'' fetus paradoxically weighted more than the ''healthy'' one. Conclusion: We concluded that SUA is an important finding during morphological ultrasound examination. When associated with other anomalies, a fetal karyotype is mandatory due to the increased risk of aneuploidy. Furthermore, the pregnancy should be meticulously monitored in order to promptly diagnose other developmental anomalies associated with abnormalities of the amniotic fluid volume and to detect any anatomical anomalies missed at the initial prenatal evaluation. Finally, we concluded that diabetes mellitus represents a strong favoring condition for SUA with first pregnancy also being a contributor.
Key words:  Single umbilical artery (SUA)      Malformation      Aneuploidy      Trisomy      Oligohydramnios      Polyhydramnios     
Submitted:  14 April 2021      Revised:  25 June 2021      Accepted:  28 June 2021      Published:  15 October 2021     
Fund: 
119.1/2019/PANMED SRL Craiova, Romania
*Corresponding Author(s):  ticaandrei2002@yahoo.com (Andrei Adrian Tica); irinatica@gmail.com (Irina Tica)   

Cite this article: 

Oana Sorina Tica, Andrei Adrian Tica, Doriana Cojocaru, Irina Tica, Victor Cojocaru, Vlad Iustin Tica. Single umbilical artery: a continuous dilemma and challenge in obstetric management. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(5): 1200-1205.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog4805191     OR     https://ceog.imrpress.com/EN/Y2021/V48/I5/1200

[1] Ozgur Sahin, H. Egemen Tolunay, Tufan Arslanca, S. Banu Arslanca. Can serum biochemical markers be used to establish a relationship between idiopathic polyhydramnios and antenatal aneuploidy?[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(5): 1071-1074.
[2] Eman Aly Abd El Fattah. Low molecular weight heparin in pregnancies with persistently abnormal uterine artery Doppler, does it make a difference? A prospective proof of concept study[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(2): 372-380.
[3] W. B. Wang, Q. Wu, Y. Zhou, X. Zhong, Y. Ge, J. Zhang. A 10-year retrospective study on prenatal cytogenetic analyses[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 248-252.
[4] F. Dessole, G. Virdis, A. Andrisani, A. Vitagliano, R. Cappadona, S. Dessole, E. Cosmi, G. Capobianco, G. Ambrosini. Fetal congenital cystic adenomatoid malformation (CCAM): pathogenesis, diagnosis, and clinical management: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 999-1002.
[5] I. Yilmaz, B. Karadas, S. Aydogmus, E. Keskin-Arslan, H. Erol-Coskun, Y. C. Kaplan. Pregnancy outcome following intentional ampicillin and pyridium overdose during the second trimester: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 842-843.
[6] K. Miura, A. Higashijima, Y. Hasegawa, S. Miura, A. Yoshida, H. Masuzaki. Decreased plasma concentrations of pregnancy-associated placenta-specific microRNAs in pregnancies with a diagnosis of fetal trisomy 18[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(6): 897-900.
[7] S. G. Erzincan, N. C. Sayin, C. Inan, M. A. Yuce, F. G. Varol, S. Basaran. Cell-free DNA testing: is it reliable? A case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(6): 939-941.
[8] D.H. Im, J.M. Byun, H.S. Jung, D.H. Jeong, B.J. Min, Y.N. Kim, E.J. Jung, K.B. Lee, M.S. Sung, K.T. Kim. The utility of Doppler ultrasonography in diagnosis of delayed postpartum hemorrhage: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(6): 946-948.
[9] Yun Chen, Yunli Lai, Shang Yi, Yanqing Tang, Yaqin Lei, Sheng Yi, Yiping Shen, Hongwei Wei. Non-invasive prenatal screening for fetal aneuploidy in twin pregnancies by cell-free DNA analysis[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(5): 656-660.
[10] N. Cim, H.E. Tolunay, B. Boza, M. Bilici, E. Karaman, O. Cetin, R. Yildizhan, H.G. Sahin. Is there any association between fetal nervous system anomalies and heavy metal-trace element levels in amniotic fluid?[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(4): 555-557.
[11] Q.C. Wu, W.B. Wang, L.K. Zheng, L. Sun, X.H. Zhong, Y.S. Xu, X.J. Xie, Z.Y. Su. Clinical investigation of congenital heart defects in prenatal life: a retrospective study on 198 cases[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(6): 870-874.
[12] L. Roncati, T. Pusiol. Arteriovenous malformations (AVM) of the corpus uteri[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(5): 764-766.
[13] L.J. Kong, L. Fan, G.H. Li, W.Y. Zhang. Prevalence of congenital malformations during pregnancy in China: screening by ultrasound examination[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(5): 772-776.
[14] P. Tsikouras, B. Manav, A. Liberis, P. Naoumis, V. Souftas, G. Galazios. Twin pregnancy in a partial septate uterus and the contribution of magnetic resonance imaging. A case report and brief literature review[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(4): 630-633.
[15] H. Aksoy, S. Özyurt, Ü. Aksoy, Ö. Özdamar, E. Mutlu, Ş. Tutuş, M.A. Babayiğit, G. Açmaz. Interobserver reliability of sonographic fetal biometry in second trimester maternal serum screening[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(3): 379-383.
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