Abuhamad A Z, Shaffer W, Mari G, Copel J A, Hobbins J C, Evans A T
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507, USA.
Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):728-32. doi: 10.1016/0002-9378(95)90331-3.
Our purpose was to determine whether the presence of congenital anomalies in fetuses with a single umbilical artery is related to the side of the missing artery.
During an 18-month prospective study, the side of the missing artery was identified in all pregnancies with a single umbilical artery (n = 77). Targeted sonograms and perinatal follow-up were obtained.
The left umbilical artery was absent in 56 of 77 (73%) fetuses, compared with 21 of 77 (27%) for the right artery, p < 0.0001. Congenital anomalies occurred in 20 of 77 (26%) fetuses, with 16 of 56 (29%) in those with absence of the left artery and 4 of 21 (19%) in those with absence of the right artery, p = 0.561. Complex congenital anomalies occurred in 9 of 20 (45%) fetuses. All complex anomalies had absence of the left artery, p = 0.103. Cytogenetic abnormalities were noted in 6 fetuses, all with absence of the left artery, p = 0.181. In fetuses with a single umbilical artery as an isolated finding, small-for-gestational-age fetuses occurred in 4 of 50 (8%) pregnancies.
In fetuses with a single umbilical artery the left artery is more commonly absent than the right artery. In our series cytogenetic and complex fetal anomalies occurred exclusively in fetuses with absence of the left artery. In contrast to previous reports, the incidence of small-for-gestational-age fetuses does not appear to be increased in cases of an isolated single umbilical artery.
我们的目的是确定单脐动脉胎儿先天性异常的存在是否与缺失动脉的侧别有关。
在一项为期18个月的前瞻性研究中，确定了所有单脐动脉妊娠（n = 77）中缺失动脉的侧别。进行了针对性超声检查和围产期随访。
77例胎儿中有56例（73%）左脐动脉缺失，右动脉缺失的有21例（27%），p < 0.0001。77例胎儿中有20例（26%）发生先天性异常，左动脉缺失的56例中有16例（29%），右动脉缺失的21例中有4例（19%），p = 0.561。20例胎儿中有9例（45%）发生复杂先天性异常。所有复杂异常均为左动脉缺失，p = 0.103。6例胎儿有细胞遗传学异常，均为左动脉缺失，p = 0.181。在以单脐动脉为孤立发现的胎儿中，50例妊娠中有4例（8%）为小于胎龄儿。
在单脐动脉胎儿中，左动脉比右动脉更常缺失。在我们的系列研究中，细胞遗传学和复杂胎儿异常仅发生在左动脉缺失的胎儿中。与先前的报道相反，孤立性单脐动脉病例中小于胎龄儿的发生率似乎并未增加。
