Disciplina de Obstetrícia, do Departamento de Obstetrícia e Ginecologia, da Faculdade de Medicina, da Universidade de São Paulo, São Paulo, SP, Brazil.
Prenat Diagn. 2011 Sep;31(9):865-8. doi: 10.1002/pd.2791. Epub 2011 Jun 27.
To determine accuracy of first trimester detection of single umbilical artery (SUA).
The number of vessels in the umbilical cord was examined in a prospective cohort of 779 singleton, low-risk, unselected pregnancies, in the first (11-13 weeks) and second (17-24 weeks) trimesters, using both power and color Doppler and after delivery, by placental histopathologic exam. Concordance between first and second trimester findings to postnatal diagnoses was compared by calculating kappa coefficients.
There was medium concordance between the findings in the first trimester and the postnatal diagnoses (kappa = 0.52) and high concordance (kappa = 0.89) for the second trimester scan. Sensitivity, specificity, positive and negative predictive values for the findings in the first trimester were 57.1, 98.9, 50.0 and 99.2% and for the second trimester were 86.6, 99.9, 92.9 and 99.7%.
Sensitivity and positive predictive value of first trimester scan to identify an isolated SUA in a prospective unselected population was poor. Diagnosis of isolated SUA as well as a definitive judgment about the presence of associated anomalies would still require a scan in the second trimester.
确定早孕期检测单脐动脉（SUA）的准确性。
在 779 例低危、未经选择的单胎妊娠前瞻性队列中，在第一（11-13 周）和第二（17-24 周）孕期使用功率和彩色多普勒超声检查脐带血管数量，并在产后通过胎盘组织病理学检查进行检查。通过计算 Kappa 系数比较第一和第二孕期检查结果与产后诊断的一致性。
第一孕期检查结果与产后诊断的一致性中等（Kappa = 0.52），第二孕期扫描的一致性较高（Kappa = 0.89）。第一孕期检查结果的敏感性、特异性、阳性预测值和阴性预测值分别为 57.1%、98.9%、50.0%和 99.2%，第二孕期检查结果的敏感性、特异性、阳性预测值和阴性预测值分别为 86.6%、99.9%、92.9%和 99.7%。
在前瞻性未选择人群中，早孕期检查识别孤立性 SUA 的敏感性和阳性预测值较差。孤立性 SUA 的诊断以及对相关异常的明确判断仍需要在第二孕期进行扫描。
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