Martínez-Payo Cristina, Gaitero Ana, Tamarit Inés, García-Espantaleón Manuel, Iglesias Goy Enrique
Gynecologic Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
Acta Obstet Gynecol Scand. 2005 Nov;84(11):1068-74. doi: 10.1111/j.0001-6349.2005.00884.x.
To study the perinatal results in our population, following the prenatal ultrasound diagnosis of a single umbilical artery (SUA), as this alteration is associated with fetal malformations, chromosomal abnormality, and poor perinatal results.
A retrospective review of all obstetric ultrasounds carried out between October 2000 and December 2003 in our service, obtaining the postnatal results of the fetuses diagnosed with an SUA.
From a total of 5,987 pregnant patients examined by ultrasound scan at 20th week, an SUA was found in 40 cases, representing an incidence of 0.7%. Of these, 84.6% were normal pregnancies at birth and 15.4% presented other malformations and/or chromosomal abnormalities. No aneuploidy was found in pregnancies where there were no other associated findings in the ultrasound scan at 20 weeks. All cases with serious congenital malformations accompanying the SUA were diagnosed prenatally. There was a 5% of perinatal mortality rate among our fetuses with SUA, which represents a mortality rate 10 times greater than the overall rate among our patients.
The ultrasound discovery of an SUA implies the meticulous search for other associated malformations, and in the absence of these, the risk of a chromosomal abnormality is very low, unless it is a high-risk patient. However, the growth and wellbeing of the fetus must be carefully monitored in the last 3 months, although the ultrasound scan does not show any other associated alterations.
研究在产前超声诊断为单脐动脉(SUA)后,我们所研究人群的围产期结局,因为这种异常与胎儿畸形、染色体异常及不良围产期结局相关。
对2000年10月至2003年12月在我们科室进行的所有产科超声检查进行回顾性分析,获取诊断为SUA的胎儿的产后结局。
在20周时接受超声检查的5987例孕妇中,发现40例SUA,发生率为0.7%。其中,84.6%出生时为正常妊娠,15.4%存在其他畸形和/或染色体异常。在20周超声检查无其他相关发现的妊娠中未发现非整倍体。所有伴有SUA的严重先天性畸形病例均在产前被诊断。我们的SUA胎儿中有5%的围产期死亡率,这比我们患者的总体死亡率高10倍。
超声发现SUA意味着要仔细寻找其他相关畸形,若不存在这些畸形,染色体异常的风险非常低,除非是高危患者。然而,尽管超声检查未显示任何其他相关改变,但在妊娠最后3个月必须仔细监测胎儿的生长和健康状况。