Case Report
Volume 1 Issue 2 - 2015
Pregnancy Outcome in Single Umbilical Artery
Obaid Al Harbyi and Hala Yousef Elean*
Department of Obstetrics & Gynecology, Prince Sultan Armed Forces Hospital, Saudi Arabia
Corresponding Author: Hala Yousef Elean, Department of Obstetrics & Gynecology, Prince Sultan Armed Forces Hospital, Saudi Arabia.
Received: March 23, 201; Published: April 02, 2015
Citation: Obaid Al Harbyi and Hala Yousef Elean. “Pregnancy Outcome in Single Umbilical Artery”. EC Gynaecology 1.2 (2015): 60-62.
Abstract
The umbilical cord typically contains two arteries and one vein. Single umbilical artery (SUA) refers to a variation of umbilical cord structure in which there is only one umbilical artery. The incidence ranges from 0.5 to 6 percent of pregnancies.
SUA is an isolated finding in approximately 65 percent of affected fetuses in the remainder, aneuploidy with or without structural malformations and intrauterine growth restriction is.
We present 3 cases with (SUA),They was delivered by lower segment cesarean section at term Mainly due to repeated caesarean, Two babies was health and third one died due to congenital heart disease with feature of Turner Syndromes.
Keywords: SUA; Embryogensis; Ultrasound; Congenital Anomalies; Intrautrin growth redudation
Introduction
Embryogenesis
The umbilical arteries develop from the allantois, a diverticulum of the yolk sac. Between 3 and 5 weeks of gestation, a transient common umbilical artery is normally present in all embryos, replacing a plexus of arteries around the allantois [1]. Subsequently, the common umbilical artery becomes shorter and right and left umbilical arteries advance within the body stalk, SUA can result from one of three mechanisms: primary agenesis of one of the definitive umbilical arteries, a secondary atrophy or atresia of a previously normal umbilical artery, or persistence of the common allantoic/umbilical artery [2].
Incidence
The incidence of SUA may be increased in women of Eastern European descent and decreased in women of Japanese and African ancestry [3].
SUA is more common in twin pregnancies (3.9 to 8.8 percent) [4].
Diagnosis
In the second and third trimesters, the American Institute of Ultrasound in Medicine recommends imaging of the umbilical cord during prenatal ultrasound examination and evaluating the number of vessels in the corde [5], but in routinely performed mid-trimester scans, only 30-67% of cases are identified. USG diagnosis is best done with color Doppler imaging [6].
Case Report 1
A 24-year-old pregnant mulliparous woman p3+0 previous 3c/s. The maternal medical histories were uneventful, as well as the family history of Hypertension, her Antenatal care regular uneventful. The Ultrasonography was performed at 30 w gestation, estimated fetal weight is 1464 gm, Umbilical Doppler normal.
Patient had elective c/s at complete 38 w under spinal anesthesia out come alive male with clear liquor. Placental apparent normal weight 700 kg with single artery sent to Histopathological Examination. The infant discharge with mother care as normal healthy infant, no evidence of congenital abnormality. Histopathology of placenta and membrane are (Placenta with degenerative change and congenital vascular anomaly of umbilical cord with one artery).
Case Report 2
A 35-year-old pregnant mulliparous woman P4+2 previous 3c/s The maternal medical histories were uneventful, as well as the family history of Hypertension and Diabetics Militias, her Antenatal care regular, With suspected fetus Small for gestation age, The Ultrasonography was performed at 30 w and 35 w gestation, confirm symmetrical intrauterine growth retardation, With liquor and umbilical Doppler was with no clear of soft marker seen at detailed u/s, Patient had emergency c/s at 37 w for fetal distress and previous 3 C/S under GA anesthesia outcome, alive female with me conium liquor, Baby weight 2,39 kg Apger score 5 & 7 & 9 @ 1 & 5 & 10 minute respectively.
Cord PH vein 7.252 cord PH artery 7.186 with single artery cord. Placental apparent small weight? kg With single artery sent to Histopathology Examination.
Histopathology Examination Report
Placenta with degenerative change and congenital vascular anomaly of umbilical cord with one artery. An infant weight 2.39 kg admitted to Nursery intensive care, Baby apparent short neck, widely nipples, Low set ear, low hair line, Echo done?? fallot teterology, Baby develop Respiratory distress syndrome With mechanical ventilation, died on day 3 with causes of death (Congenital Heart Diseases with features of Turners Syndroms), karyotype not available.
Case Report 3
A 30 year-old pregnant nulliparous woman, Primegravida 38w +1d Unbooked, no antenatal, The maternal medical histories were uneventful, as well as the family history uneventful. Patient had emergency c/s under spinal anesthesia for fetal distress outcome, alive female with, Meconium liquor, baby weight 2.8 kg Apger score 4 & 8 @ 1 & 5 MIN respectively with single artery cord. Placental apparent normal small weight 300 kg with single artery. The infant discharge with mother care as normal healthy infant, no evidence of congenital abnormality.
Histopathology Examination Report
Placenta with degenerative change and congenital vascular anomaly of umbilical cord with one artery.
Conclusion
Fetuses and neonates with single umbilical artery and isolated single umbilical artery are at increased risk for adverse outcomes. Identification of single umbilical artery is important for prenatal diagnosis of congenital anomalies and aneuploidy. Increased surveillance with isolated single umbilical artery may improve pregnancy outcomes.
Bibliography
  1. Granese R., et al. “The value of single umbilical artery in the prediction of fetal aneuploidy: findings in 12,672 pregnant women”. Ultrasound Quarterly 23.2 (2007): 117-121.
  2. Bianchi DW., et al. “Diagnosis and Management of the Fetal Patient”. McGraw Hill, New York (2000): 827.
  3. Persutte WH and Hobbins J. “Single umbilical artery: a clinical enigma in modern prenatal diagnosis”. Ultrasound in Obstetrics & Gynecology 6 (1995): 216.
  4. Naeye RL. “Disorders of the umbilical cord”. In: Disorders of the placenta, fetus and neonate. Mosby-Year Book Inc., St Louis, MO (1992): 92.
  5. AIUM Practice Guideline for the Performance of Obstetric Ultrasound Examinations.
  6. Gornall AS, et al. “Antenatal detection of a single umbilical artery: Does it matter?”. Prenatal Diagnosis 23.2 (2003): 117-123.
Copyright: © 2015 Hala Yousef Elean., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events

November Issue Release

We Always feel pleasure to share an update with you all. Here, notifying you that we have successfully released November issue for the respective journals and can be viewed in the current issue pages.

Submission Deadline for January Issue

E-Cronicon delightfully welcome all the authors around the globe for an effective collaboration with an article submission for the January issue of respective journals. Submissions are accepted on/before December 17, 2019.

Certificate of Publication

E-Cronicon honours with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Special Issue Update for the Month of November

Editorial office of E-Cronicon (EC) is here with a great initiation to plan a special edition for the month of November. This special edition is intend to concentrate on new helpful, innovative solutions that are aimed at ensuring better quality in the management of treatment. We firmly believe that sharing of experience and visionary ideas will give beginning to solutions that will give hope for increased effectiveness in the prevention and treatment of various health issues which is considered to be an epidemic of the researchers and society. We would like to encourage you to participate in this unique edition so that we can work together to develop an optimistic concept for a better health perspective for patients. I hope to have the participation of every author who are in association with E-Cronicon to this special issue by making it a successful initiation. List of journals planning for November special edition: 1. EC Ophthalmology (ECOP) 2. EC Paediatrics (ECPE) 3. EC Pulmonology and Respiratory Medicine (ECPRM) 4. EC Gastroenterology and Digestive System (ECGDS) 5. EC Cardiology (ECCY). More information can be found in the special issue pages of these journals. Best paper will be picked by the Editorial office and will be provided with an "Appreciation Certificate". Take a smallest step by dropping your opinions to editor@ecronicon.uk for a biggest success.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

E-Cronicon certify the Editors for their first review done towards assigned article of the respective journals.

Latest Articles

Latest articles will be updated immediately in the articles in press page of the respective journals.

Immediate Assistance

Prime moto of this team is to clarify all the queries without any delay or hesitation in order to avoid the inconvenience. For an immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk