Can fetal echocardiogram and karyotyping be fairly offered for fetal umbilical cord abnormalities?

Abstract EN

Aim : A prospective study to determine if fetal echocardiography and karyotyping by amniocentesis are strongly indicated in fetus with single umbilical artery (SUA).

Patients and Methods : during the period from March 2002-September 2006 all cases of fetal SUA, from Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia, in a routine obstetric population were studied.

Targeted sonograms and perinatal follow up were obtained.

Results : Sixteen thousand women completed the study, 162 cases of SUA were diagnosed on the basis of prenatal sonograms, however 169 cases (53 non isolated SUA and 116 isolated SUA) confirmed postnatal.

The sensitivity, specificity, positive predictive value and negative predictive value of prenatal ultrasonography diagnosis of SUA were 90.5 %, 99.9 %, 94.4% and 99.8 % respectively.

Aneuploidy and cardiac abnormalities were present in 8 out of the 53 (15 %) and 17 / 53 (32 %) in none isolated SUA respectively.

Conclusion : fetuses with SUA should get further evaluation at centers that handle high-risk cases and parent should strongly counseled for fetal echocardiogram and fetal karyotyping in case of none isolated SUA.