Conexão de artéria umbilical única isolada com feto

Ultrasound Obstet Gynecol 2013; 42: 622–628

Published online 24 October 2013 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.12541

Relationship of isolated single umbilical artery to fetal

growth, aneuploidy and perinatal mortality: systematic

review and meta-analysis

B. J. VOSKAMP*, H. FLEURKE-ROZEMA†, K. OUDE-RENGERINK*, R. J. M. SNIJDERS†,

C. M. BILARDO†, B. W. J. MOL* and E. PAJKRT*

*Department of Obstetrics, University Medical Centre AMC Amsterdam, Amsterdam, The Netherlands; †Department of Obstetrics and

Prenatal Diagnosis, University of Groningen, University Medical Centre UMCG Groningen, Groningen, The Netherlands

KEYWORDS: aneuploidy; birth weight; isolated; single umbilical artery; small for gestation; ultrasound

ABSTRACT

Objective To review the available literature on outcome

of pregnancy when an isolated single umbilical artery

(iSUA) is diagnosed at the time of the mid-trimester

anomaly scan.

Methods We searched MEDLINE (1948–2012),

EMBASE (1980–2012) and the Cochrane Library (until

2012) for relevant citations reporting on outcome of

pregnancy with iSUA seen on ultrasound. Data were

extracted by two reviewers. Where appropriate, we

pooled odds ratios (ORs) for the dichotomous outcome

measures: small for gestational age (SGA), perinatal mortality

and aneuploidy. For birth weight we determined

the mean difference with 95% CI.

Results We identified three cohort studies and four

case–control studies reporting on 928 pregnancies with

iSUA. There was significant heterogeneity between cohort

and case–control studies. Compared to fetuses with a

three-vessel cord, fetuses with an iSUA were more likely

to be SGA (OR 1.6 (95% CI, 0.97–2.6); n=489) or suffer

perinatal mortality (OR 2.0 (95% CI, 0.9–4.2); n=686),

although for neither of the outcomes was statistical

significance reached. The difference in mean birth weight

was 51 g (95% CI, –154.7 to 52.6 g): n=407), but again

this difference was not statistically significant. We found

no evidence that fetuses with iSUA have an increased risk

for aneuploidy.

Conclusion In view of the non-significant association

between iSUA and fetal growth and perinatal mortality,

and in view of the heterogeneity in studies on aneuploidy,

we feel that large-scale, prospective cohort studies are

needed to reach definitive conclusions on the appropriate

Correspondence to: Dr B. J. Voskamp, Academic Medical Centre, Department of Obstetrics & Gynaecology, Room H4-236, Meibergdreef

9, 1105 AZ Amsterdam, The Netherlands (e-mail: [e-mail])

Accepted: 7 June 2013

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