Sun Lulu, Wang Yanlin
a Department of Obstetrics and Gynecology , International Peace Maternity and Child Health Hospital of China Welfare Institute , Shanghai , China.
b Department of Prenatal Diagnosis Center , International Peace Maternity and Child Health Hospital of China Welfare Institute , Shanghai , China.
J Matern Fetal Neonatal Med. 2018 May;31(9):1118-1123. doi: 10.1080/14767058.2017.1309384. Epub 2017 Apr 3.
Identify structural anomalies and adverse pregnancy outcomes accompanying single umbilical artery (SUA) and persistent right umbilical vein (PRUV) and to investigate whether SUA and PRUV are associated with chromosomal abnormalities and if these defects warrant invasive antenatal diagnosis.
We retrospectively analyzed pregnancies with an antenatal diagnosis of SUA/PRUV from the International Peace Maternity and Child Health Hospital (IPMCHH) database. Data of structural malformations, fetal karyotyping, and pregnancy outcomes were analyzed.
Results revealed that 13.9 and 7% of SUA and PRUV cases, respectively, had malformations. Furthermore, 60% of the malformations accompanying SUA were isolated congenital heart disease (CHD), and 50% of the malformations accompanying PRUV were multiple malformations including CHD. All primarily diagnosed isolated PRUV (iPRUV) cases and 92.6% of primarily diagnosed iSUA cases had normal fetal echocardiography. Cases of iSUA and iPRUV with indications of invasive antenatal diagnosis showed no chromosomal abnormalities. The emergency cesarean section rate did not differ between the study population and the IPMCHH general population (p = .184).
Patients of SUA and PRUV diagnosed in secondary hospitals should be referred to tertiary medical center for further ultrasonography. SUA and PRUV are not indicators for invasive antenatal diagnosis and selective cesarean section.
识别单脐动脉(SUA)和持续性右脐静脉(PRUV)伴随的结构异常及不良妊娠结局,并研究SUA和PRUV是否与染色体异常相关,以及这些缺陷是否需要进行侵入性产前诊断。
我们回顾性分析了国际和平妇幼保健院(IPMCHH)数据库中产前诊断为SUA/PRUV的妊娠病例。分析了结构畸形、胎儿核型分析和妊娠结局的数据。
结果显示,SUA和PRUV病例中分别有13.9%和7%存在畸形。此外,SUA伴随的畸形中60%为孤立性先天性心脏病(CHD),PRUV伴随的畸形中50%为包括CHD在内的多发畸形。所有最初诊断为孤立性PRUV(iPRUV)的病例以及92.6%最初诊断为iSUA的病例胎儿超声心动图均正常。有侵入性产前诊断指征的iSUA和iPRUV病例未显示染色体异常。研究人群与IPMCHH普通人群的急诊剖宫产率无差异(p = 0.184)。
在二级医院诊断为SUA和PRUV的患者应转诊至三级医疗中心进行进一步超声检查。SUA和PRUV不是侵入性产前诊断和选择性剖宫产的指征。