Single umbilical artery. A report of 159 cases
A. K. Leung and W. L. Robson
Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Canada.
We retrospectively reviewed the records of 56,919 infants born from 1966
through 1986 to determine the incidence, significance, and possible
associations of single umbilical artery (SUA). One hundred fifty-nine
infants were affected. The sex distribution was approximately equal.
Fourteen infants (8.8%) were twins who were discordant for SUA. The
smallest twin was the one affected in all but two cases. Of the 159
infants, 16 were stillborn and 19 died neonatally. The mean birth weight of
all infants with SUA was 2.47 kg, and the mean gestational age was 35.9
weeks. Young primipara and older multipara mothers were more commonly
affected. There was an increased incidence of SUA associated with maternal
diabetes, epilepsy, toxemia, antepartum hemorrhage, hydramnios, and
oligohydramnios. Twenty-six (16.4%) of the associated placentas had
anomalies. Seventy-one infants (44.7%) had other congenital malformations.
The presence of these malformations was associated with increased
mortality. Screening for renal anomalies with ultrasonography or
intravenous pyelography was performed in 27 patients and yielded positive
results in five (18.5%). We recommend that renal ultrasonography be
performed on all infants with SUA.
