Journal Mobile Options
Table of Contents
Vol. 32, No. 3, 2012
Issue release date: November 2012
Fetal Diagn Ther 2012;32:201–208

Single Umbilical Artery: Does Side Matter?

Santillan M. · Santillan D. · Fleener D. · Stegmann B. · Zamba G. · Hunter S. · Yankowitz J.
aDepartment of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, bDepartment of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, and cDepartment of Obstetrics and Gynecology, University of South Florida, Tampa, Fla., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Introduction: The aim of this study was to determine if laterality of an absent umbilical artery (AUA) is associated with specific sonographic findings, chromosomal defects or postpartum birth defects. Materials and Methods: In this retrospective cohort study, ultrasound reports and medical records of patients who received an obstetric ultrasound at the University of Iowa Hospitals and Clinics with an identified laterality of the AUA from 1989 to 2007 (n = 405) were reviewed. Rates of sonographic abnormalities between fetuses with a right versus left AUA were compared using Fisher’s exact test. Adjustments for confounding were made using logistic regression modeling. The significance level was set at 0.05. Results: Right AUAs on ultrasound demonstrate higher unadjusted rates of ultrasound abnormalities with a higher percentage of fetuses with >1 additional abnormality (51.1 vs. 37.0%; p = 0.0043). The left AUA group had a significantly higher percentage of isolated AUA (63.0 vs. 48.8%; p = 0.004). In a multivariate analysis, a sonographic right AUA was significantly associated with gastrointestinal (GI) and genitourinary (GU) abnormalities. No other ultrasonographic and umbilical artery Doppler abnormalities, chromosomal defects or postpartum birth defects were significantly associated with a specific laterality of the AUA. Discussion: Our study identified a significant association between a right AUA and concomitant fetal GI and GU abnormalities. Contrary to previous reports, we conclude that laterality of the AUA may prove to be an easily identified early marker of fetal abnormalities.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Lilja M: Infants with single umbilical artery studied in a national registry. General epidemiological characteristics. Paediatr Perinat Epidemiol 1991;5:27–36.
  2. Jones TB, Sorokin Y, Bhatia R, Zador IE, Bottoms SF: Single umbilical artery: accurate diagnosis? Am J Obstet Gynecol 1993;169:538–540.
  3. Gornall AS, Kurinczuk JJ, Konje JC: Antenatal detection of a single umbilical artery: does it matter? Prenat Diagn 2003;23:117–123.
  4. Cristina MP, Ana G, Ines T, Manuel GE, Enrique IG: Perinatal results following the prenatal ultrasound diagnosis of single umbilical artery. Acta Obstet Gynecol Scand 2005;84:1068–1074.

    External Resources

  5. Heifetz SA: Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature. Perspect Pediatr Pathol 1984;8:345–378.
  6. Granese R, Coco C, Jeanty P: The value of single umbilical artery in the prediction of fetal aneuploidy: findings in 12,672 pregnant women. Ultrasound Q 2007;23:117–121.

    External Resources

  7. Catanzarite VA, Hendricks SK, Maida C, Westbrook C, Cousins L, Schrimmer D: Prenatal diagnosis of the two-vessel cord: implications for patient counselling and obstetric management. Ultrasound Obstet Gynecol 1995;5:98–105.
  8. Herrmann UJ Jr, Sidiropoulos D: Single umbilical artery: prenatal findings. Prenat Diagn 1988;8:275–280.

    External Resources

  9. Leung AK, Robson WL: Single umbilical artery. A report of 159 cases. Am J Dis Child 1989;143:108–111.
  10. Parilla BV, Tamura RK, MacGregor SN, Geibel LJ, Sabbagha RE: The clinical significance of a single umbilical artery as an isolated finding on prenatal ultrasound. Obstet Gynecol 1995;85:570–572.
  11. Lee CN, Cheng WF, Lai HL, Cheng SP, Shih JC, Shyu MK, Kau ML, Hsieh FJ: Perinatal management and outcome of fetuses with single umbilical artery diagnosed prenatally. J Matern Fetal Investig 1998;8:156–159.

    External Resources

  12. Abuhamad AZ, Shaffer W, Mari G, Copel JA, Hobbins JC, Evans AT: Single umbilical artery: does it matter which artery is missing? Am J Obstet Gynecol 1995;173:728–732.
  13. Lubusky M, Dhaifalah I, Prochazka M, Hyjanek J, Mickova I, Vomackova K, Santavy J: Single umbilical artery and its siding in the second trimester of pregnancy: relation to chromosomal defects. Prenat Diagn 2007;27:327–331.
  14. Blazer S, Sujov P, Escholi Z, Itai BH, Bronshtein M: Single umbilical artery – right or left? Does it matter? Prenat Diagn 1997;17:5–8.
  15. Fukada Y, Yasumizu T, Hoshi K: Single umbilical artery: correlation of the prognosis and side of the missing artery. Int J Gynaecol Obstet 1998;61:67–68.
  16. Geipel A, Germer U, Welp T, Schwinger E, Gembruch U: Prenatal diagnosis of single umbilical artery: determination of the absent side, associated anomalies, Doppler findings and perinatal outcome. Ultrasound Obstet Gynecol 2000;15:114–117.
  17. Joo JG, Beke A, Berkes E, Papp Z, Rigo J Jr, Papp C: Fetal pathology in second-trimester miscarriages. Fetal Diagn Ther 2009;25:186–191.

    External Resources

  18. Hadlock FP, Deter RL, Harrist RB, Park SK: Estimating fetal age: computer-assisted analysis of multiple fetal growth parameters. Radiology 1984;152:497–501.
  19. Goldstein I, Reece EA, Pilu G, Bovicelli L, Hobbins JC: Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development. Am J Obstet Gynecol 1987;156:1065–1069.
  20. Pretorius DH, Drose JA, Manco-Johnson ML: Fetal lateral ventricular ratio determination during the second trimester. J Ultrasound Med 1986;5:121–124.
  21. Mahony BS, Callen PW, Filly RA, Hoddick WK: The fetal cisterna magna. Radiology 1984;153:773–776.
  22. Nicolaides KH, Azar G, Byrne D, Mansur C, Marks K: Fetal nuchal translucency: ultrasound screening for chromosomal defects in first trimester of pregnancy. BMJ 1992;304:867–869.
  23. Brenner WE, Edelman DA, Hendricks CH: A standard of fetal growth for the United States of America. Am J Obstet Gynecol 1976;126:555–564.
  24. Jeanty P, Romero R: Obstetrical Ultrasound. New York, McGraw-Hill, 1984.
  25. Acharya G, Wilsgaard T, Berntsen GK, Maltau JM, Kiserud T: Reference ranges for serial measurements of umbilical artery Doppler indices in the second half of pregnancy. Am J Obstet Gynecol 2005;192:937–944.
  26. Moore TR, Cayle JE: The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol 1990;162:1168–1173.
  27. Zalel Y, Perlitz Y, Gamzu R, Peleg D, Ben-Ami M: In-utero development of the fetal colon and rectum: sonographic evaluation. Ultrasound Obstet Gynecol 2003;21:161–164.
  28. Bianchi DW: Fetology: Diagnosis and Management of the Fetal Patient, ed 2. New York, McGraw-Hill, 2010.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50