Действительно при аплазии артерии пуповины наблюдается многократное увеличение неблагоприятных исходов беременности (преждевременные роды, задержка роста плода, антенатальная и неонатальная гибель).
Это тезисы одного из докладов на последнем (август 2008) конгрессе ISUOG.
Association of isolated single umbilical artery with adverse
perinatal outcome in 18,224 unselected patients.
S. S. E. Taher, J. Eliahoo, S. Kumar, A. Plumeridge,P. Bennett. (London,UK).
Objectives: To determine the possible association between fetuses
diagnosed with isolated single umbilical artery at 20–23 weeks
gestation and intrauterine fetal growth restriction (IUGR), preterm
labour (PTL), and fetal distress in labour as a primary cause for
operative delivery.
Methods: A retrospect study of all fetuses diagnosed with isolated
single umbilical artery (no minor or major anomalies) between
January 2003 to December 2007 in tertiary referral centre. Any
referred case for second opinion had been excluded. Fetuses with
single umbilical artery and associated anomalies had been excluded.
Results: Isolated single umbilical artery was diagnosed in 79/18224
(0.43%). In 4/79 (5%) had intrauterine fetal death, 3/79 (3.8%)
had spontaneous preterm labour at 35, 34, 29 weeks gestation,
in 3/79(3.8%) fetuses had intrauterine fetal growth restriction
(<2.5 Kg at term).
After exclusion of intrauterine deaths (3 cases), the mean gestation at
delivery was 38.7 (29–42) weeks. The mean birth weight at delivery
was 3155(2558–4520) grams.
Regard the mode &indication of delivery 53% of fetuses had
spontaneous uncomplicated vaginal delivery while 47% had
operative delivery. Caesarean delivery rate was 30% with emergency
onset in 12.9%. Fetal distress in labour considered as a primary
indication in 45% of caesarean deliveries.
Conclusions: in our series, fetuses diagnosed with isolated single
umbilical artery, likely to have increased risk of intrauterine death
(LR: 10) increased risk of operative delivery intervention and
intrapartum fetal distress as a primary indication of operative
delivery.
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