Isolated Single Umbilical Artery and Fetal Echocardiography: A 25-Year Experience at a Tertiary Care City Hospital.

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  • Additional Information
    • Source:
      Publisher: John Wiley and Sons Country of Publication: England NLM ID: 8211547 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1550-9613 (Electronic) Linking ISSN: 02784297 NLM ISO Abbreviation: J Ultrasound Med Subsets: MEDLINE
    • Publication Information:
      Publication: 2017- : Oxford, UK : John Wiley and Sons
      Original Publication: [Philadelphia, Pa.] : W.B. Saunders, c1982-
    • Subject Terms:
      Echocardiography/*methods ; Fetal Heart/*diagnostic imaging ; Heart Defects, Congenital/*diagnostic imaging ; Ultrasonography, Prenatal/*methods ; Umbilical Arteries/*diagnostic imaging; Adult ; Female ; Hospitals, Urban ; Humans ; Pregnancy ; Retrospective Studies ; Tertiary Care Centers ; Tertiary Healthcare
    • Abstract:
      Objectives: To review our 25-year experience with a single umbilical artery and fetal echocardiography to estimate the need for this test in cases of an isolated single umbilical artery.
      Methods: We conducted a retrospective review of 436 patients with a diagnosis of a single umbilical artery at our institution between 1990 and 2015. Two hundred eighty-eight women had both an anatomic survey and a fetal echocardiogram. Pregnancies with concurrent extracardiac anomalies or aneuploidy were excluded. The study population was divided into 3 groups based on cardiac views on the anatomic survey: normal, incomplete, and suspicious. Echocardiographic results were compared among the 3 groups. The primary outcome measure was the incidence of cardiac anomalies in the normal group at fetal echocardiography. The data were analyzed by the χ 2 test or Fisher exact test.
      Results: The mean maternal age ± SD of the group was 29.2 ± 6.2 years; 44.1% were primiparas. The mean gestational age at diagnosis was 22.6 ± 5.2 weeks, and the mean gestational age at fetal echocardiography was 25.1 ± 3.6 weeks. In the normal group, 99.1% (230 of 232) of women had a normal fetal echocardiogram; the 2 abnormal cases were ventricular septal defects. Normal echocardiograms were obtained in 81.8% (36 of 44) and 25.0% (3 of 12) of the "incomplete" and "suspicious" groups, respectively.
      Conclusions: Fetuses with a single umbilical artery, in the absence of structural abnormalities, and with normal cardiac views at the time of the anatomic survey do not warrant an echocardiogram.
      (© 2017 by the American Institute of Ultrasound in Medicine.)
    • Contributed Indexing:
      Keywords: congenital heart disease; fetal echocardiography; obstetrics; single umbilical artery
    • Publication Date:
      Date Created: 20170830 Date Completed: 20180905 Latest Revision: 20180905
    • Publication Date:
      20240829
    • Accession Number:
      10.1002/jum.14353
    • Accession Number:
      28850695