Mehmet Ş. ÖZKAN, Gülnur ÖZAKŞİT, Evrim ALYAMAÇ DİZDAR, Ayla AKTULAY, Nuri DANIŞMAN, Necati HANÇERLİOĞULLARI, Hakan TİMUR, Yaprak ENGİN ÜSTÜN

Tekil Gebelerde İzole Tek Umbilikal Arter: Maternal ve Yenidoğan Sonuçları

Giriş: Tek umblikal arter TUA en yaygın umblikal kord anomalisidir. Çalışmanın amacı tek umblikal kordu olan gebeliklede maternal ve perinatal sonuçların incelenmesidir.Gereç ve Yöntemler: Çalışmamız hastanemizde yürütülen retrospektif bir çalışmadır. Bu retrospektif kohort çalışmada tek umblikal arter tanısı almış ve kanıtlanmış ek bir anomalisi olmayan hastaların maternal ve neonatal sonuçları incelenmiştir. Maternal yaş, doğum haftası, doğum kilosu, doğum şekli, fetal cinsiyet ve diğer komplikasyonlar kaydedilmiştir.Bulgular: Antenatal olarak tespit edilmiş 42 TUA vakası saptanmıştır. Gestasyonel yaşın 258-289 gün arasında dağıldığı saptanmıştır. Median maternal yaş 28 olarak saptanmıştır 19-36 . Gravida 2 olarak saptanmıştır 1-4 . 5 gebelik invitro fertilizayon sonrası oluşmuş olup, 2 gebelikte prematür membran rüptürü gözlenmiştir. Tek umblikal arterli 2 bebekte kriptorşitizm ve 1 bebekte hipotiroidi saptanmıştır. Erkek cinsiyet %50 oranında saptanmıştır.Sonuç: Tek umblikal arter izole bir ultrasonografi bulgusu olduğunda da kriptorşitizm gibi minör defektler gözlenebilmektedir.

Anahtar Kelimeler:

Fetal sonuçlar, tek umblikal arter, umblikal kord

Isolated Single Umbilical Artery In Singleton Pregnancies: Maternal and Neonatal Outcomes

Aim: Single umbilical artery SUA is the most common umbilical cord abnormality. The aim of the study was to evaluate maternal and neonatal outcomes in pregnancies with single umbilical artery.Material and Methods : This was a retrospective study from a tertiary referral center. In this retrospective cohort study, maternal and neonatal outcomes of patients who had a diagnosis of single umbilical artery without an established anomaly werereviewed. Maternal age, gestational age at delivery, birth weight, mode ofdelivery, fetal gender and any complications were recorded.Results : There were 42 cases of SUA without an antenatally diagnosedestablished anomaly. Gestational age ranged between 258-289 days. Median maternal age was 28 19-36 years. Gravida was 2 1-4 . There were five in vitro fertilization pregnancies, and two pregnancies with premature rupture of membranes. Two of the neonates with single umbilical artery had cryptorchidism and one had hypothyroidism. Male gender was 50%.Conclusion : When the single umbilical artery is an isolated ultrasonography finding, neonates will still have a possibility of having minor problems such as cryptorchidism.

Keywords:

Neonatal outcome, single umbilical artery, umblical cord,

PDF

___

Tasha I, Brook R, Frasure H, Lazebnik N. Prenatal Detection of Cardiac Anomalies in Fetuses with Single Umbilical Artery: Diagnostic Accura- cy Comparison of Maternal-Fetal-Medicine and Pediatric Cardiologist. J Pregnancy 2014, doi: 10.1155/2014/265421. Article ID 265421, 8 pages
Murphy-Kaulbeck L, Dodds L, Joseph KS, Van den Hof M. Single umbi- lical artery risk factors and pregnancy outcomes. Obstet Gynecol 2010; 116: 843-50.
Jones TB, Sorokin Y, Bhatia R, Zador IE, Bottoms SF. Single umbilical artery: accurate diagnosis? Am J Obstet Gynecol 1993; 169: 538-540.
Khalil MI, Sagr ER, Elrifaei RM, Abdelbasit OB, Halouly TA. Outcomes of an isolated single umbilical artery in singleton pregnancy: a large study from the Middle East andGulf region. Eur J Obstet Gynecol Reprod Biol 2013; 171: 277-280
Chow JS, Benson CB, Doubilet PM. Frequency and nature of structu- ral anomalies in fetuses with single umbilical arteries. J Ultrasound Med.1998; 17:765-768
Martínez-Payo C, Gaitero A, Tamarit I, García-Espantaleón M, Iglesias Goy E. Perinatal results following the prenatal ultrasound diagnosis of single umbilical artery. Acta Obstet Gynecol Scand 2005;84:1068–1074
Heifetz SA. Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol 1984:345–378
Geipel A, Germer U, Welp T, Schwinger E, Gembruch U. Prenatal diagno- sis of single umbilical artery: determination of the absent side, associa- ted anomalies, Doppler findings and perinatal outcome.Ultrasound Obstet Gynecol.2000;15:114-117
Persutte WH, Hobbins J. Single umbilical artery: a clinical enigma in mo- dern prenatal diagnosis. Ultrasound Obstet Gynecol 1995;6:216-229.
Prefumo F, Guven MA, Carvalho JS. Single umbilical artery and conge- nital heart disease in selected and unselected populations. Ultrasound Obstet Gynecol 2010;35:552–555.
Dagklis T, Defigueiredo D, Staboulidou I, Casagrandi D, Nicolaides KH. Ultrasound Obstet Gynecol. 2010;36:291-295.
Chang Q, Chen C, Zhong M,Qiu Y, Xiao C, Huang Q, Yu Y. Prenatal diagno- sis of single umbilical artery: implications for chromosomal abnormalities and neonatal outcome. Nan Fang Yi Ke Da XueXueBao 2013;33:451-453.
Predanic M, Perni SC, Friedman A, Chervenak FA, Chasen ST. Fetal growth assessment and neonatal birth weight in fetuses with an isolated single umbilical artery. Obstet Gynecol. 2005;105:1093-1097
Voskamp BJ, Fleurke-Rozema H, Oude-Rengerınk K, Snıjders RJM, Bilar- do CM, Mol BWJ, Pajkrt E. Relationship of isolated single umbilical artery to fetal growth, aneuploidy and perinatal mortality: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2013; 42: 622-628.
Horton AL, Barroilhet L, Wolfe HM. Perinatal outcomes in isolated single umbilical artery. Am J Perinatol 2010;27:321-324.
Salihoglu O, Karatekin G, Uslu S, Can E, Baksu B, Nuhoglu A. New intra- uterine growth percentiles: a hospital-based study in Istanbul, Turkey. J Pak Med Assoc. 2012;62:1070–1074.
Tülek F, Kahraman A, Taşkın S, Özkavukçu E, Söylemez F. Determination of risk factors and perinatal outcomes of singleton pregnancies complip- cated by isolated single umbilical artery in Turkish population. J Turk Ger Gynecol Assoc. 2015;16:21-24.
Burshtein S, Levy A, Holcberg G, Zlotnik A, Sheiner E.Is single umbilical artery an independent risk factor for perinatal mortality? Arch Gynecol Obstet. 2011;283(2):191-194
Ashwal E, Melamed N, Hiersch L, Edel S, Bardin R, Wiznitzer A, Yogev Y. The impact of isolated single umbilical artery on labor and delivery outcome. Prenat Diagn. 2014;34:581–585.