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The impact of isolated single umbilical artery on labor and delivery outcome
Author(s) -
Ashwal Eran,
Melamed Nir,
Hiersch Liran,
Edel Sacha,
Bardin Ron,
Wiznitzer Ar,
Yogev Yariv
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4352
Subject(s) - medicine , umbilical artery , obstetrics , pregnancy , apgar score , birth weight , small for gestational age , gestational age , fetus , vaginal delivery , single umbilical artery , umbilical cord , intrauterine growth restriction , low birth weight , genetics , anatomy , biology
Objective Data regarding the association between isolated single umbilical artery (SUA) and pregnancy outcome are inconsistent and mainly address the risk of pregnancy complications. Thus, we aimed to focus on the association between isolated SUA, and labor and delivery. Methods We conducted a case–control study of all singleton pregnancies diagnosed with isolated SUA (no known chromosomal/structural anomalies/fetal growth restriction) attempting vaginal delivery. Obstetric and neonatal outcome was compared with that of a control group of pregnancies with a three‐vessel cord in a 1:2 ratio matched by parity. Composite adverse outcome included the following: Cesarean section (CS) and/or operative delivery due to non‐reassuring fetal heart rate (NRFHR), prolonged neonatal admission, low Apgar score and umbilical artery pH < 7.2. Results Out of 34 196 deliveries, 162 (0.5%) were diagnosed with SUA, and 91 (0.27%) were diagnosed with isolated SUA. Isolated SUA was associated with a higher rate of CS due to NRFHR (5.5% vs 1%, p = 0.02), small for gestational age (SGA) (14.3% vs 4.9%, p = 0.009), lower birth weight, and a higher rate of composite adverse outcome (20.9% vs 8.8%, p = 0.005). On multivariable analysis, isolated SUA was independently associated with an increased risk for composite adverse outcome (OR 2.34, 95% CI 1.05–5.21). Conclusion Isolated SUA is associated with increased risk for CS due to NRFHR and increased rate of SGA. © 2014 John Wiley & Sons, Ltd.