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Relationship of isolated single umbilical artery to fetal growth, aneuploidy and perinatal mortality: systematic review and meta-analysis.
- Source :
-
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology [Ultrasound Obstet Gynecol] 2013 Dec; Vol. 42 (6), pp. 622-8. Date of Electronic Publication: 2013 Oct 24. - Publication Year :
- 2013
-
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.<br />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.<br />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.<br />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 work-up in iSUA pregnancies. At present, targeted growth assessment after diagnosis of iSUA should not be routine practice.<br /> (Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.)
- Subjects :
- Aneuploidy
Female
Fetal Development
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Odds Ratio
Pregnancy
Risk
Single Umbilical Artery diagnostic imaging
Ultrasonography, Prenatal
Birth Weight
Fetal Growth Retardation epidemiology
Perinatal Mortality
Single Umbilical Artery epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1469-0705
- Volume :
- 42
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 23775879
- Full Text :
- https://doi.org/10.1002/uog.12541