This document summarizes a case study of a 24-year-old pregnant woman who is 33 weeks pregnant with intrauterine growth restriction (IUGR). An ultrasound revealed she has a single umbilical artery. Her previous pregnancy involved hydrocephalus and a meningomyelocele. The single umbilical artery was further examined with color Doppler which showed altered Doppler parameters, likely due to the reduced size of the single artery and reduced resistance. IUGR and associated abnormalities can also impact Doppler assessment. The fetus showed measures close to the lower limit of standard deviation, suggestive of IUGR. Associated IUGR was observed. Normal umbilical cords contain two umbilical arteries and one vein, while single umbilical arteries

1. SINGLE UMBILICAL ARTERYSingle umbilical artery (SUA) has an incidence of 0.5% witha higher prevalence in twin pregnancies. The aetiologyremains unknown but the most likely mechanism is atrophy of the second umbilical artery during development 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.MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARHMERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH

2. Umbilical artery SINGLE UMBILICAL ARTERY ON GREY SCALE

3. SINGLE UMBILICAL ARTERY WITH MAGNIFIED VIEW

4. COLOR DOPPLER ASSESMENTAltered 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.

5. All the fetalParametres for the growth of the are close to the lower limit of the standard deviation suggestive of IUGR.

6. Associated IUGR is appreciated in the study .Note is made of significant basal / chorionic plate calcification. Placental post maturity .........

7. Normal umbilical CordThe normal umbilical cord consists of two umbilical arteriesand one umbilical vein surrounded by Wharton’s jelly.

8. A brief about single umbilical arterySingle umbilical artery is the most congenital abnormality of the umbilical cord.Associated with 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 IUGR , IUD Premature labour .. EtiopathogenesisPrimary agenesisRegression of preformed artery .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.

9. A suggested protocol...........A detailed sonographic evaluation with fetal echocardiography.