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PubMed2005

Pregnancy outcome of fetuses with a diagnosis of hypoplastic left ventricle on prenatal sonography.

OBJECTIVE: The goal of our study was to assess the pregnancy outcome of fetuses with a diagnosis of hypoplastic left heart syndrome (HLHS) on prenatal sonography to determine the frequency of intrauterine fetal demise (IUFD) and any factors associated with IUFD. METHODS: We reviewed all cases with the diagnosis of HLHS on prenatal sonography at our institution from 1992 through 2003. Data collected included gestational age at diagnosis, sonographic findings, karyotype testing, and pregnancy outcome. RESULTS: Our study included 176 fetuses with HLHS. One hundred thirty-four fetuses were liveborn; 32 pregnancies were terminated; 3 IUFDs occurred; and outcome was unknown in 7. Of the 134 liveborn fetuses, 2 had abnormal karyotypes and 30 had other anomalies. Two of the 3 fetuses with IUFD had abnormal karyotypes, 1 with trisomy 13 and 1 with trisomy 18, and both had other anomalies on sonography. The third fetus with IUFD had no other anomalies but was 1 of triplets, and the karyotype was unknown. CONCLUSIONS: Fetuses with HLHS diagnosed prenatally who have normal chromosomes are unlikely to die in utero.

Abnormalities, Multiple↗

PubMed2006

Middle cerebral artery blood flow velocimetry among healthy fetuses with a single umbilical artery.

OBJECTIVE: A single umbilical artery (SUA) is an independent risk factor for perinatal morbidity and mortality in healthy fetuses. The aims of the study were (1) to determine middle cerebral artery (MCA) blood flow velocimetric values among fetuses without structural or chromosomal anomalies with an SUA and to compare them with nomograms of patients with a 3-vessel cord and (2) to measure the pulsatility index (PI) of the umbilical artery among these patients. METHODS: The PI values of the MCA and umbilical arteries were determined prospectively among 98 healthy fetuses with an SUA. The PI values were compared with nomograms of patients with a 3-vessel umbilical cord. For the MCA, peak systolic velocity (PSV) was also measured. Patients carrying fetuses with intrauterine growth restriction or congenital anomalies were excluded from the study. Middle cerebral artery PI values below the fifth percentile and PSV values above the 95th percentile adjusted for gestational age were considered abnormal. RESULTS: Gestational age ranged between 22 and 37.9 weeks (median, 30.3 weeks). After adjusting for gestational age, no alterations in the MCA PI and umbilical PI were found in comparison with the normal range for a 3-vessel cord known in the literature. Middle cerebral artery PSV values were also within the normal range for gestational age in all patients. CONCLUSIONS: The MCA PI and PSV values among healthy fetuses with an isolated SUA were similar to nomograms for fetuses with a 3-vessel umbilical cord. Therefore, abnormal MCA PI and PSV values among fetuses with an SUA should be treated the same as in patients with a 3-vessel umbilical cord.

Adult↗

PubMedDate not supplied

[Incidence of aplasia of the umbilical artery in fetuses with intrauterine retardation].

The author analysed the occurrence of the aplasia of the umbilical artery in 320 umbilical cords of fetuses with intrauterine retardation and in 225 umbilical cords of normal fetuses and a normal course of pregnancy used as controls. Aplasia of the umbilical artery in umbilical cords of fetuses with intrauterine retardation was found in 5.93% and in the control group in 0.44% of cases (P less than 0.05). Fetuses with intrauterine retardation and aplasia of the umbilical artery showed a velamentous insertion of the umbilical cord in 31.57% of cases, an approximate duration of pregnancy of 36 weeks and 5 days, and the mean birth weight of 2250 +/- 2 S.D. 420 g. Out of 19 fetuses with intrauterine retardation and aplasia of the umbilical artery, 6 had congenital anomalies which in 50% of cases could not be detected by external examination. Perinatal mortality of fetuses with intrauterine retardation and aplasia of the umbilical artery proved to amount to 368.43% and of fetuses in the control group to 8.88% (P less than 0.05).

Congenital Abnormalities↗

PubMed1999

The effects of maternal protein restriction on the growth of the rat fetus and its amino acid supply.

Maternal protein deficiency causes fetal growth retardation which has been associated with the programming of adult disease. The growth of the rat fetus was examined when the mothers were fed on diets containing 180, 90 and 60 g protein/kg. The numbers of fetuses were similar in animals fed on the 180 and 90 g protein/kg diets but the number was significantly reduced in the animals fed on the 60 g protein/kg diet. The fetuses carried by the mothers fed on the 90 g protein/kg diet were 7.5% heavier than those of mothers fed on 180 g protein/kg diet on day 19 of gestation, but by day 21 the situation was reversed and the fetuses in the protein-deficient mothers were 14% smaller. Analysis of the free amino acids in the maternal serum showed that on day 19 the diets containing 90 and 60 g protein/kg led to threonine concentrations that were reduced to 46 and 20% of those found in animals fed on the control (180 g/kg) diet. The other essential amino acids were unchanged, except for a small decrease in the branched-chain amino acids in animals fed on the 60 g protein/kg diet. Both low-protein diets significantly increased the concentrations of glutamic acid+glutamine and glycine in the maternal serum. On day 21 the maternal serum threonine levels were still reduced by about one third in the group fed on the 90 g protein/kg diet. Dietary protein content had no effect on serum threonine concentrations in nonpregnant animals. Analysis of the total free amino acids in the fetuses on day 19 showed that feeding the mother on a low-protein diet did not change amino acid concentrations apart from a decrease in threonine concentrations to 45 and 26% of the control values at 90 and 60 g protein/ kg respectively. The results suggest that threonine is of particular importance to the protein-deficient mother and her fetuses. Possible mechanisms for the decrease in free threonine in both mother and fetuses and the consequences of the change in amino acid metabolism are discussed.

Amino Acids↗

PubMed2000

Analysis of the spectrum of malformations in human fetuses of the second and third trimester of pregnancy with human triploidy.

Triploidy is constituted by an extra haploid set of chromosomes for a total of 69 chromosomes in humans. A "parent-of-origin" effect has been demonstrated by analysis of cytogenetic polymorphisms of triploidy pregnancies. Two distinct phenotypes of human triploid fetuses have been recognized according to the parental origin of the extra haploid set. The first one or triploidy of diandric type occurs when the extra haploid set of chromosomes arises from the father, the second one or triploidy of digynic type occurs when the extra haploid set of chromosomes arises from the mother. Diandric fetuses appear relatively well grown with a large placenta, while digynic fetuses show intrauterine growth retardation with a small placenta. Autopsy archive data files (1982-1998) of the Institute of Pathology, University of Heidelberg (Germany) were examined for fetuses with triploidy. We found 12 well-studied triploid fetuses (gestational age: 20 to 32 weeks). Eleven fetuses corresponded to the digynic type of triploidy and one fetus corresponded to the diandric type of triploidy. The spectrum of external malformations included a dysmorphic face (broad root of the nose, exophthalmos, low-set ears, micro-/retrognathia, microgenia, median cleft lip and/or palate, gnathoschisis, macroglossia), encephalocele, spina bifida, syndactyly, club or rocker-bottom feet, pes equino-valgus. More common internal malformations included ventricular septum defect of the heart, abnormal lobation of the lungs, and renal disease (agenesis, cysts).

Abnormalities, Multiple↗

PubMed2003

An echocardiographic study of tetralogy of Fallot in the fetus and infant.

OBJECTIVE: To document the echocardiographic features of tetralogy of Fallot during fetal and postnatal life. Correlation of echocardiographic findings with the requirement for early intervention prior to definitive repair. DESIGN: Retrospective observational study. SETTING: A tertiary fetal cardiology unit. PATIENTS: Fetuses with a diagnosis of tetralogy of Fallot identified from a prospective database between 1 January 1999 and 31 October 2002. MAIN MEASURES OF OUTCOME: Growth of aorta and pulmonary trunk during fetal and postnatal life. Doppler assessment of the great arteries both prenatally and postnatally. Clinical outcome to definitive repair. RESULTS: We identified 25 fetuses with tetralogy of Fallot, 23 having a pulmonary valvar diameter below the normal range at some point during gestation. The ratio of the diameter of the aortic to the pulmonary valve was abnormal in all cases. The pulmonary arterial Doppler velocity was within the normal range in six fetuses at presentation,and elevated in the remainder. In two fetuses, the right ventricular outflow tract was patent during fetal life, but had become atretic at birth. Both of these fetuses had reversal of flow in the arterial duct at presentation during fetal life. In 2 fetuses in whom we showed poor growth of the pulmonary trunk in late gestation, it was necessary to intervene early. The Doppler velocity across the pulmonary valve during fetal life did not differentiate between babies who required early intervention and those who were repaired electively. There was a marked increase in pulmonary arterial Doppler velocity following birth, which became more elevated with age. Of 18 liveborn infants, 17 have survived, with 2 having balloon dilation of the right ventricular outflow tract, and 3 insertion of a Blalock-Taussig shunt prior to definitive repair. CONCLUSIONS: In tetralogy of Fallot, features of pulmonary valvar hypoplasia and obstruction are evident during fetal life. Progression of obstruction in the right ventricular outflow tract was observed during fetal life as well as postnatally. Reversal of flow in the arterial duct, and failure of growth of the pulmonary trunk, predicted the need for early surgery to maintain pulmonary blood flow. Parents should be counselled about the possibility of emergency intervention being required after birth. Affected fetuses should be delivered at units with experience of managing the cyanosed newborn.

Aorta↗

PubMed1992

Cerebral energy metabolism in immature and mature guinea pig fetuses during acute asphyxia.

In immature fetuses circulatory centralization caused by acute asphyxia is less effective than that in mature fetuses (Jensen & Berger, 1991). This suggests that cerebral oxygenation may be poor in immature fetuses during asphyxia. On the other hand cerebral oxygen consumption is lower in immature than that in mature fetuses. To determine, whether or not there is an imbalance between oxygen supply and demand in one or the other group, we compared the time course of the changes of cerebral concentrations of both high-energy phosphates and glycolytic intermediates between immature and mature guinea pig fetuses during acute asphyxia caused by arrest of uterine blood flow. The fall in the cerebral concentrations of adenosine triphosphate and glucose, and the rise in those of adenosine monophosphate and lactate were slower in immature than in mature fetuses. There were no differences between the levels of cerebral adenosine diphosphate and creatine phosphate of the two groups. From these results we conclude that during acute asphyxia the imbalance between cerebral oxygen supply and demand is less marked in immature than in mature fetuses.

Acute Disease↗

PubMed2004

[Anterior abdominal wall defects--retrospective analysis of fetuses diagnosed in the Department of Obstetrics & Gynecology of the Postgraduate Center of Medical Education between 1997 & 2002].

OBJECTIVES: Our objectives were to determine the risk of aneuploidy and anatomic anomalies in fetuses with different kinds of abdominal wall defects. DESIGN: We retrospectively studied ultrasound reports of the fetuses with abdominal wall defects. MATERIALS AND METHODS: We analyzed 108 cases diagnosed during the last five years in our center. All fetuses underwent a detailed ultrasonographic survey and in majority of cases (78.8%) antenatal karyotyping was performed. We also analyzed gestational age at the first examination. RESULTS: 35 cases presented gastroschisis, 60 omphalocele, 7 ectopia cordis and 6 limb-body wall complex. Associated anomalies were detected in 48.1% of all cases. It was 22.9% in gastroschisis group, 58.3% in omphalocele group, 42.9% in ectopia cordis group and in all fetuses with limb-body wall complex. Chromosomal abnormalities were present in 13% of all cases; in 2.9% of gastroschisis group, 20% of omphalocele group, 16.7% of limb-body wall complex group and none of the fetuses with ectopia cordis. The median gestational age at the first examination was 24 weeks. CONCLUSIONS: In fetuses with abdominal wall defects detailed ultrasonographic survey and in majority of cases prenatal karyotyping should be done. Furthermore patients with fetus with such a defect should be diagnosed as early as possible in the referral center.

Abdominal Wall↗

PubMed2005

[Intrauterine death of one fetus during the first trimester of monochorionic diamniotic twin gestation].

OBJECTIVES: The goal of our study was the clinical and pathological characteristics of the monochorionic diamniotic twin gestations complicated by the intrauterine death of one fetus during the first trimester. MATERIAL AND METHODS: This study is a prospective review of 9 monochorionic diamniotic twin gestations involving the intrauterine death of one fetus during the first trimester. RESULTS: During the study period 178 twin gestations were identified sonographically during the first trimester. Forty three of them (24,2%) were complicated by the intrauterine death of one fetus before the end of 12th gestation week. Nine cases were monochorionic diamniotic. Gestational age of one fetus demise ranged from 5 to 11 (mean 7,4) weeks. Prognoses for surviving fetus were adverse. In 8 cases there was a death of a second fetus after the period of 1 to 3 weeks, with abortion of both fetuses. Only in one case, the gestation has finished in 40th week by delivery of liveborn infant. Maternal coagulation changes did not occur in those cases. One liveborn infant was without evidence of hematological and neurological abnormalities. The postdelivery examination allowed to establish a presence of monochorionic diamniotic placentation in all cases. In two of them, the probable causes of death were established (developmental defect, presence of anastomoses between blood vessels). CONCLUSION: These results suggest that the risk of mortality for the living twin is very high, after the death of its sibling, in case of monochorionic placentation. Morphological examination of placenta and fetal membranes lets to establish a type of placenta, and in some cases a probable cause of intrauterine death of one twin during the first trimester of monochorionic diamniotic twin gestation.

Adult↗

PubMed2005

[Distribution of the epicardiac neural ganglia in human fetuses of different age].

OBJECTIVE: The epicardiac neural ganglia of the adult human heart are distributed in the seven neural ganglionated subplexuses. The aim of the present investigation was to determine the distribution of the epicardiac ganglia in human fetuses of different age, because intrinsic cardiac nervous system of the human fetus has not been enough investigated so far. MATERIAL AND METHODS: In the present study seventeen human fetus hearts were investigated, in which epicardiac neural ganglionated plexus was visualized by histochemical method for acetylcholinesterase. RESULTS: Analysis of the total hearts preparations showed that: (1) the epicardiac neural ganglionated plexus of the fetus at fifteen weeks of gestation has already differentiated into seven ganglionated subplexuses, structure of which is typical for the adult human heart; (2) the epicardiac plexus of fetuses at 15-40 weeks of gestation contains on average 865+/-40 epicardiac ganglia, that may widely range in number from 644 to 1193; (3) the largest number of the neural ganglia is concentrated on the posterior surface of both atria, where up to 76% of all ganglia maybe located; (4) the difference between the number of epicardiac ganglia in the human fetuses at the early (15-25 weeks) and late (26-40 weeks) stages of fetogenesis is not statistically significant (p>0.05). In conclusion, both the distribution and the number of the epicardiac ganglia of fetuses ranging from 15 to 40 weeks of gestation are not age-dependent but varied substantially from heart to heart.

Acetylcholinesterase↗

PubMed1990

Hematologic evaluation of growth retarded fetus by cordocentesis.

Fetal blood sampling by ultrasound-guided cordocentesis was performed in 22 IUGR fetuses in order to evaluate the fetal condition. All patients were referred to our hospital for further examination and management. In addition to hematological assessment we measured the velocity profiles of the umbilical artery with pulse-gated Doppler equipment. On the whole, pH and pO2 in the umbilical vein of IUGR fetuses were significantly lower and pCO2 higher, respectively, the corresponding values in controls. In particular, IUGR fetuses which had an etiology of maternal pre-eclampsia had fallen into hypoxemia. However, other laboratory values in IUGR did not differ from those of the controls except for the platelet count, which was low in the IUGR fetuses. Five fetuses with chromosomal abnormalities were found by analyzing the fetal blood. Since there are different etiologies inducing IUGR, fetus and umbilical artery velocimetry is not always predictive of the state of the IUGR fetus, hematological assessment is considered indispensable for further management.

Blood Chemical Analysis↗

PubMed1990

A quantitative analysis of placental vasculature in the third-trimester fetus with autosomal trisomy.

Growth disturbance in the trisomic fetus is believed to be primarily fetal in origin. There has been only sparse description of placental pathology in the third trimester in these fetuses, and therefore the placental role in their growth and development remains unexplored. We performed quantitative morphometric analysis on the placentas of 18 fetuses with trisomy and ten normal control fetuses. Doppler umbilical artery analysis was performed on ten abnormal fetuses and all controls. The placentas of trisomic fetuses exhibited a significant reduction in small muscular artery count and small muscular artery/villus ratio. Abnormal Doppler waveforms correlated closely with reduced small muscular artery counts. Undervascularization and increased vascular resistance of the placenta of trisomic fetuses may contribute to diminished fetal growth. The placenta appears to be another fetal organ whose structure and function are affected adversely by abnormal karyotype.

Arterioles↗

PubMed1979

Breathing movements before death in the primate fetus (Macaca mulatta).

The incidence and character of fetal breathing movements (FBMs) were determined by analysis of continuous tracheal pressure recordings in a 48 hour period preceeding fetal death in utero in 7 chronic pregnant monkey preparations (Macaca mulatta). All fetuses were judged normal by blood gas tensions, pH, and fetal heart rate within 48 hours of death. In the normal fetus breathing movements were periodic and a circadian distribution in the incidence of FBMs was observed. Four distinct patterns of FBMs were observed in the normal fetuses. In five fetuses death occurred in the intrapartum period; all five fetuses were breathing at the onset of labor. A progressive fall in the incidence of FBMs was observed in labor coincident with the development of fetal acidemia. In the remaining two fetuses death occurred before labor. Apnea and gasping were observed in all fetuses before death. The duration of apnea and gasping appeared dependent upon the nature of the lethal insult.

Animals↗

PubMed1984

Lung development in the nephrectomized ovine fetus.

The effect of fetal nephrectomy on lung development was studied in sheep. Fetal kidneys were removed early in the canalicular stage of lung development (95 to 99 days of pregnancy) and lung structure examined during the alveolar stage (125 to 134 days of gestation). Progesterone and estradiol 17 beta concentrations in maternal and fetal plasma were normal for gestational age, thus indicating that the ewes were not close to labour at the time the fetuses were removed. Mean body weight was significantly reduced in nephrectomized fetuses (P less than 0.05). Overall growth of the fetal lung was not markedly affected by fetal nephrectomy. However, compared to controls, alveolar airspaces were smaller in the cranial lobes of nephrectomized fetuses (P less than 0.05) and made up a smaller percentage of the parenchyma for the whole lung. There were fewer lamellar bodies per type 2 alveolar cell in nephrectomized fetuses (P less than 0.05), and more cells were without lamellar bodies (P less than 0.01). Umbilical venous thyroxin (T4) concentrations were lower in nephrectomized fetuses compared to control values (P less than 0.005). Plasma thyroxin concentration in nephrectomized fetuses correlated directly with thyroid weight (P less than 0.02). There was no significant difference in cortisol concentrations in maternal or fetal plasma or fetal tracheal fluid between the two groups. It is thus possible that the delayed lung development observed in nephrectomized fetuses was related to reduced thyroid activity.

Animals↗

PubMed1983

Morphological development of the thyroid gland and serum T4-concentration in the intact and decapitated pig fetus.

The morphological and functional development of the fetal pig thyroid gland between 50 and 110 days post coitum have been examined in the normal pig fetus and after fetal decapitation at 42 days postcoitum. Body length and body weight developed at the same rate, comparing control and decapitated animals. Thyroid gland weight increased between 50 days and 110 days from 1.3 +/- 0.5 mg (SD) to 130.0 +/- 35.0 mg in control fetuses and from 0.9 +/- 0.2 mg to 113.4 +/- 23.0 mg in decapitated fetuses. A number of histomorphometrical parameters in thyroid tissue were measured. No significant differences in follicular epithelial height were observed between decapitated and control animals at 75 and 110 days. In control animals follicles increased both in size and number. In decapitated animals the follicles increased strikingly in number, but only slightly in size. Although colloid was formed in glands of decapitated animals, it was much less than in control fetuses. The gland of decapitated animals of 110 days resembled histologically the gland of much younger control animals (60 to 75 days). Gland development after fetal decapitation at 42 days may represent autonomous development when Thyroid Stimulating Hormone (TSH) is depleted. Serum thyroxine concentration (T4) was determined by radioimmunoassay and increased in control animals from 0.06 +/- 0.01 micrograms/100 ml to 4.18 +/- 0.87 micrograms/100 ml at 110 days, the greatest rate of increase being observed between 64 and 90 days. In decapitated fetuses serum T4 remained very low, namely less than 0.20 micrograms/100 ml. It is very unlikely that any significant transfer of T4 from mother to fetus or from one fetus to another occurred. Both the rise in serum T4 and the enlargement of the follicles may be TSH dependent events in fetal pig thyroid gland development, whereby the sudden rise is serum T4 precedes the greatest rate of increase in follicle size.

Animals↗

PubMed1993

The relationship between heart rate and asphyxia in the animal fetus.

In order to understand the mechanisms which regulate and control basal heart rate as well as heart rate variability in the fetus, a number of studies have been conducted in fetal animals. Information has been obtained largely from fetal sheep during the last third of gestation, although recently investigators have directed their attention to earlier gestations, such as 80-90 days, with term in the sheep being 145 days. A few studies have focused on the non-human primate fetus for additional information. A variety of techniques has been utilized experimentally to produce hypoxemia and/or acidemia in fetal animals, including umbilical cord compression, maternal hypoxemia, and uterine blood flow restrictions. Evidence to date would indicate that both chemoreceptors and baroreceptors are present and active in the late gestation sheep fetus, giving rise to acute changes in fetal heart rate (FHR) with changes in oxygenation. Factors which must be considered in interpreting alterations in both mean FHR and FHR variability in response to a decrease in oxygenation include: 1) the mechanism giving rise to decrease in oxygen delivery, 2) the duration of hypoxemia and/or asphyxia, 3) the effect of sleep states and behavioural activity, 4) gestational age, and 5) condition of the fetus prior to the decrease in oxygen delivery. Heart rate variability in fetal sheep has been studied extensively and it has been shown that accelerations in the FHR are closely associated with skeletal muscle activity much like the human fetus, suggesting similar control mechanisms in the 2 species. The late gestation sheep fetus consistently and reliably experiences an increase in heart rate variability with acute hypoxemia with and without acidemia until severe acidosis develops. In contrast, the hypoxemic human fetus, prior to labour, generally exhibits a decrease in FHR variability. The explanation for this apparent species difference remains unclear.

Animals↗

PubMed1996

[A comparison of plasma amino acid concentrations between appropriate and small for gestational age fetuses].

OBJECTIVE: To investigate the role of amino acid played in pathogenesis of small for gestational age (SGA) fetuses. METHODS: Plasma amino acids' concentrations (PAAC) of umbilical venous samples obtained by cordocentesis before labor or at cesarean section were measured in 30 cases of appropriate for gestational age (AGA) fetuses at different gestational age. PAAC of both mother and fetuses were measured and compared in 10 cases of SGA and 10 cases of AGA. RESULTS: In cases of AGA, the PAAC in fetuses (3.11 +/- 0.41 mmol/L) were found to be higher than that in mothers. There were significant correlations between fetal and maternal PAAC. The total PAAC in mothers and fetuses, and its ratios were not changed with gestational age. In cases of SGA, essential amino acids' concentration (EAA), especially branch chain amino acid (BCAA) and lysine, decreased significantly. The feto-maternal ratios of EAA and BCAA were reduced significantly, whereas concentrations of EAA and BCAA in mothers did not change significantly. CONCLUSIONS: The results indicated that placental function and maternal nutrient supplement were important factors for maintaining fetal growth and development. In AGA cases, relationship of PAAC between mothers and fetuses were kept in a stable balance. In SGA fetuses certain amino acid metabolic disturbances existed. The reduction of some PAAC was not due to their decrease in mothers.

Amino Acids, Branched-Chain↗

PubMed1998

Perinatal Management and Outcome of Fetuses with Single Umbilical Artery Diagnosed Prenatally.

> Objective: To investigate the perinatal management and outcome of fetuses diagnosed prenatally with single umbilical artery. Methods: Sixty-one consecutive fetuses with single umbilical artery diagnosed prenatally by ultrasonography were included. Thorough prenatal ultrasonographic screening was carried out to detect associated congenital anomalies. Chromosome study by either amniocentesis or cordocentesis was performed for all 61 of the fetuses with single umbilical artery. Thorough physical examination or autopsy was performed after delivery. Results: All 61 fetuses were confirmed to have single umbilical artery after delivery. Ten (16.4%) of the 61 fetuses with single umbilical artery had abnormal karyotypes. In the single umbilical artery group with abnormal karyotyping, 8 had detectable structural abnormalities, 1 had symmetrical intrauterine growth retardation, and 1 had no apparent congenital anomalies. For the 51 fetuses with normal karyotyping, 28 had abnormal ultrasonographic findings. In 23 fetuses with single umbilical artery without chromosomal or structural anomalies diagnosed in utero, 7 (30.4%) were found to have structural anomalies (3 with congenital heart disease, 3 with congenital renal disease, and 1 with limb deformity) after birth. Conclusion: Prenatal diagnosis of single umbilical artery should be made with caution to avoid false positive cases. When single umbilical artery is diagnosed prenatally, we suggest 1) targeted ultrasonography for detection of anomalies with cardiovascular, genitorenal, and limb-skeletal systems; 2) chromosome study for those with intrauterine growth retardation or other associated defects; and 3) thorough investigation after birth.

Journal Article↗