Single Umbilical Artery: Associated Findings and Management

Key Associations with Single Umbilical Artery

• The American College of Obstetricians and Gynecologists notes that cardiovascular anomalies are strongly associated with Single Umbilical Artery (SUA), with odds ratios ranging from 5.9 to 20.3 for various cardiac defects 1, 2
• Renal anomalies show a 3-fold increased risk, with approximately 16% of isolated SUA cases having some form of renal anomaly 1, 2

Chromosomal Abnormalities

• The American College of Medical Genetics and Genomics states that when SUA occurs with other structural abnormalities, the frequency of associated aneuploidy ranges from 4% to 50% 1, 2
• Isolated SUA shows no increased risk of aneuploidy, according to the American College of Obstetricians and Gynecologists 1, 2

Perinatal Morbidity and Mortality

• The American Academy of Pediatrics reports that SUA is associated with a nearly 5-fold increased risk of stillbirth (OR 4.80, 95% CI 2.67-8.62) 1, 2

Clinical Management Implications

• The American College of Obstetricians and Gynecologists recommends a comprehensive anatomic survey with particular attention to cardiovascular and renal systems when SUA is identified 1, 2
• The Society for Maternal-Fetal Medicine suggests third-trimester ultrasound to evaluate fetal growth, and weekly antenatal surveillance beginning at 36 weeks gestation for isolated SUA 1, 2