Zhenduanxue lilun yu shijian (Feb 2023)

Prenatal ultrasound analysis of single umbilical artery and combined malformations

  • YAN Bing, CHEN Ping, CAO Yunyun, XU Qiuqin

DOI
https://doi.org/10.16150/j.1671-2870.2023.01.005
Journal volume & issue
Vol. 22, no. 01
pp. 31 – 36

Abstract

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Objective: To analyze the incidence of single umbilical artery (SUA) diagnosed by prenatal ultrasound and the types of combined fetal structural malformations. Methods: A retrospective analysis was performed on 141 577 singleton pregnancies who underwent continuous prenatal ultrasonography in Children’s Hospital of Soochow University from January 1, 2013 to January 31, 2022. Based on postpartum umbilical cord data or pathological examination，the incidence of SUA in singleton pregnancies was calculated and the combined malformations were analyzed. Results: The incidence of SUA was 0.55% (778/141 577) in singleton pregnancy, with isolated single umbilical artery (iSUA) accounting for 60.93% (474/778) and non-isolated single umbilical artery (niSUA) accounting for 39.07% (304/778). The absence rate of the left and right umbilical arteries was 51.7% (402/778) and 48.3% (376/778), respectively. The SUA with absence of right umbilical artery had a higher incidence of malformation comorbidities than those with absence of left umbilical artery [44.95% (169/376) vs. 33.58% (135/402)] (P=0.023 1). The frequency of malformations was 477 in 304 SUA fetuses, and cardiovascular malformation was the most commonly seen, accounting for 36.27% (173/477). Chromosomal examination was performed in 487 fetuses,with a chromosomal abnormalities rate of 8.83%(43/487). Incidence of chromosomal abnormalities in niSUA fetuses (13.79%,28/203) was significantly higher than that in iSUA fetuses (5.28%,15/284) (P=0.001 1). The incidence of chromosomal abnormalities rose along with the increase in the number of malformations in fetuses with four or more malformations, reaching 37.5% (3/8). Trisomy 18 syndrome was the most common abnormal chromosome karyotype (30.23%, 13/43). Conclusions: The incidence of SUA in singleton pregnancies is 0.55%, and iSUA accounts for 39.07%. Among SUA combined fetal malformations, cardiovascular malformations are the most common, with a proportion of 37.5%. When ultrasound indicates the presence of four or more malformations in fetuses, 40% of them may accompany with chromosome karyotype abnormalities.

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