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Re: Question on Single Umbilical Artery Pregnancies

From: Joel (anonymous@obgyn.net)
Tue, 06 May 1997 13:30:03 +0200


Geffrey H. Klein, MD wrote: >
> Hello all. Sorry to
> >submit a question to
> >you all but I'm struggling to find a place
> >to ask this question.
> >
> >My sister-in-law is 38 years old. She is
> >starting her 5 month of pregnancy and has
> >just been informed (through an amnio) that
> >she has a single umbilical artery that is now
> >feeding her unborn child. In addition she
> >was told that they found 2 markers and
> >chromosome 13 and 21. Excuse my terminology.
> >I have no medical background whatsoever.
> >
> >Anyway, she's struggling on trying to decide
> >if she should have this baby. Her OBGYN has
> >not gotten into any details with her and describe
> >to her any seriousness this could be.
> >
> >What are the potential birth defects or
> >proven baby's that have been born with only
> >being fed through a single umbilical artery.
> >And have some babies survived this without
> >any problems?
> >
> >If you could respond asap that would be great!!
> >She only has until the beginning of next
> >week to decide if she should continue on
> >with her pregnancy.
>
> I direct you to this study:
>
> Authors
> Blache G. Garba A. Frairot P. Vancina S. Gaja R.
> Institution
> Service de Gynecologie-Obstetrique, Centre Hospitalier General, Roanne.
> Title
> [Prognostic value of a single umbilical
> artery. 87 cases]. [Review] [34 refs] [French]
> Source
> Journal de Gynecologie, Obstetrique et Biologie de la Reproduction.
> 24(5):522-8, 1995.
> Abstract
> OBJECTIVE. To study the effect of a single
> umbilical artery on infant prognosis.
> METHOD. Unicentric retrospective case-control study based on 18,425 births
> and semi-late pregnancy interruptions. RESULTS. There were
> 87 cases of single umbilical
> artery, frequently associated with a familial history of
> malformation in the sibhood (6.8%), gravid pathology (hypertension 11.5%,
> diabetes 6.8%), funicular anomaly (32%). One or several malformations were
> seen in 21% of the infants, the main cause of infant mortality (9%) and
> morbidity. The case-control study demonstrated that single
> umbilical artery corresponded to a moderate
> reduction in weight (-310 g), term (-1.4 weeks gestation), AGPAR scor at 1
> and 5 minutes (-0.7) which was not significant when single
> umbilical artery was the sole pathology.
> CONCLUSION. When occurring alone, single
> umbilical artery has little effect on
> infant prognosis which is more dependant on associated malformations and
> gravid pathologies determining antenatal and postnatal management.
> [References: 34]
>
> What it says is that found alone without other anomalies, a single
> umbilical artery is of no serious consequence
>
> Best of luck...

I've made a study on Single Umbilical artery. I agree with that conclusion : if alone, no problem. BUT you must have a very performant US exam, not a routin one. I can send you the whole text of the study Geffrey spoke of, but it's in French ! Let me know your personnal post adress if you want it.

--
Joel Kompanietz, M.D. CNGOF,
OBGYN.net International Representative, France
Mazamet, France

*Note: Opinions expressed here are for educational purpose only. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options.




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