SINGLE UMBILICAL ARTERY<br />Single umbilical artery (SUA) has an incidence of 0.5% with<br />a higher prevalence in twin pregnancies. The aetiology<br />remains unknown but the most likely mechanism is atrophy of the second umbilical artery during development <br /> PRESENT CASE : 24 yr Old Female with POG by USG of 33 wks with IUGR. USG / Doppler assesment has e/o single umbilical artery . Previous pregnancy had e/o Hydrocephalus with Meninigocele.<br />MERCURY IMAGING INSTITUTE <br />SCO 172-173 SEC 9C CHANDIGARH<br />MERCURY IMAGING CENTRE <br />SCO 16-17 SEC 20D CHANDIGARH<br />
SINGLE UMBILICAL ARTERY WITH MAGNIFIED VIEW<br />
COLOR DOPPLER ASSESMENT<br />Altered dopplerparametres in the umbilical artery may be sequael to large size of the single umbilical artery and reduced resistance in the same . IUGR , associated abnormalities can also alter the dopplerassesment.<br />
All the fetalParametres for the growth of the are close to the lower limit of the standard deviation suggestive of IUGR. <br />
Associated IUGR is appreciated in the study .<br />Note is made of significant basal / chorionic plate calcification. Placental post maturity .........<br />
Normal umbilical Cord<br />The normal umbilical cord consists of two umbilical arteries<br />and one umbilical vein surrounded by Wharton’s jelly. <br />
A brief about single umbilical artery<br />Single umbilical artery is the most congenital abnormality of the umbilical cord.<br />Associated with <br />Hollow organ atresia . Gastrointestinal and urogenital abnormalities, musculoskeletal, cardiovascular and central nervous system malformations and limb reduction defects , Cystic renal dysplasia , meckels syndrome , posterior uretheral valve , anterior uretheraldiverticulum , uretheral agenesis <br />IUGR , IUD <br />Premature labour .. <br />Etiopathogenesis<br />Primary agenesis<br />Regression of preformed artery .<br />Coagulopathy , Endothelial dysfunction , Ischemic sequale are possible mechanisms that can lead to mentioned vascular disruption. Altered blood supply of rest of the developing organs can also disturb there genesis and hence can lead to atresia.<br />
A suggested protocol...........<br /><ul><li>A detailed sonographic evaluation with fetal echocardiography.
Finding of a second pertinent sonographic abnormality is an indication for karyotype determination.
Clinical growth Monitoring for the remainder of the pregnancy appears indicated, augmented by Doppler velocimetry where there is clinical concern.
Counselling of the parents should include a description of the recognized associations andimpact on fetal/perinatal mortality.</li>