Usefulness of Routine Screening for Infants with Single Umbilical Artery

ABSTRACT

PURPOSE: Single umbilical artery is usually detected by antenatal fetal sonography or by postnatal primary physical exams. Routine screening test is usually recommended because of frequent association with abnormalities in multiple organs or in chromosomes. This study was performed to find the necessity of evaluating combining anomalies and chromosomes in neonates with single umbilical artery. METHODS: Retrospective analysis had been performed based on admission records and laboratory data, including simple X-ray, echocardiography, abdominal sonography, and chromosomal study, of 6, 636 neonates born last decade from September, 1993 to August, 2003 at Ewha Womans University hospital. RESULTS: There were 73 (1.1%) neonates born with single umbilical artery that matched the incidence in general population. Congenital malformation was observed in 28 neonates which included cardiovascular (n=16, 21.9%), gastrointestinal (n=6, 8.2%), geni tourinary (n=5, 6.8%), musculoskeletal (n=4, 5.5%), central nervous system (n=1, 1.4%), and other (n=1, 1.4%) abnormalities. No chromosomal abnormalities were detected in this group. CONCLUSION: Because the incidences of structural abnormalities in genitourinary system, gastrointestinal system and cardiovascular system were high as previously reported, it is highly recommended to perform imaging studies including echocardiography and abdominal sonography to screen these anomalies. However necessity of the chromosomal study should be reconsidered based on large study population in isolated single umbilical artery patient.