Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.
Ultrasound Obstet Gynecol. 2010 Nov;36(5):553-5. doi: 10.1002/uog.7711.
To examine the association between single umbilical artery (SUA) and cardiac defects and to determine whether patients with SUA require specialist fetal echocardiography.
Incidence and type of cardiac defects were determined in fetuses with SUA detected at routine second-trimester ultrasound examination.
A routine second-trimester scan was performed in 46 272 singleton pregnancies at a median gestation of 22 (range, 18-25) weeks and an SUA was diagnosed in 246 (0.5%). Cardiac defects were diagnosed in 16 (6.5%) of these cases, including 10 (4.3%) in a subgroup of 233 with no other defects and in six (46.2%) of the 13 with multiple defects. In 11 (68.8%) of the 16 cases with cardiac defects the condition was readily diagnosable by evaluating the standard four-chamber view and the views of the great arteries. In the remaining cases there was left persistent superior vena cava or small ventricular septal defect, where prenatal diagnosis may not be important because they are not associated with adverse outcome.
Although SUA is associated with an increased incidence of cardiac defects it may not be necessary to refer such patients for specialist fetal echocardiography because the defects are detectable by evaluating standard cardiac views that should be part of the routine second-trimester scan.
探讨单脐动脉（SUA）与心脏缺陷的关系，并确定是否需要对 SUA 患者进行专门的胎儿超声心动图检查。
在常规的妊娠中期超声检查中检测到 SUA 的胎儿中，确定心脏缺陷的发生率和类型。
在中位数为 22 周（范围 18-25 周）的 46272 例单胎妊娠中进行了常规的妊娠中期扫描，其中 246 例（0.5%）诊断为 SUA。在这些病例中，有 16 例（6.5%）诊断出心脏缺陷，其中 10 例（4.3%）存在于 233 例无其他缺陷的亚组中，6 例（46.2%）存在于 13 例存在多种缺陷的病例中。在 16 例心脏缺陷病例中，有 11 例（68.8%）通过评估标准四腔心切面和大血管切面即可明确诊断。在其余病例中，存在左永存上腔静脉或小室间隔缺损，这些病例产前诊断可能并不重要，因为它们与不良结局无关。
尽管 SUA 与心脏缺陷的发生率增加有关，但可能不必将此类患者转介进行专门的胎儿超声心动图检查，因为通过评估应作为常规妊娠中期扫描一部分的标准心脏切面即可检测到这些缺陷。
