Iranian Society of Gynecology Oncology

Document Type : Case Report Article


1 Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran

2 USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran

3 Department of Obstetrics and Gynecology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran


Single umbilical artery (SUA) is an uncommon yet clinically noticeable anomaly that has been suspected to be correlated with a wide range of pregnancy complications. We hereby present a 30-year-old pregnant woman who was diagnosed with SUA fetus in the 20th week of her pregnancy and was admitted to our center in the 33rd week. During the hospitalization, Doppler studies were performed to monitor fetal development. Later, fetoplacental insufficiency and brain-sparing effect were reported on Doppler ultrasound, indicating asymmetrical Intrauterine growth restriction (IUGR). SUA might be associated with concurrent fetal anomalies including cardiological, nephrological, gastrointestinal, and nervous disorders. Moreover, there is an increased risk of small for gestational age and IUGR compared with normal pregnancies. It is crucial to assess the umbilical cord anatomy during pregnancy to diagnose SUA at lower gestational ages and schedule a precise follow-up to prevent adverse outcomes.


Main Subjects

1. Krzyżanowski A, Kwiatek M, Gęca T, Stupak A, Kwaśniewska A. Modern Ultrasonography of the Umbilical Cord: Prenatal Diagnosis of Umbilical Cord Abnormalities and Assessement of Fetal Wellbeing. Med Sci Monit. 2019;25:3170-80. [DOI:10.12659/MSM.913762] [PMID] [PMCID]
2. Gornall AS, Kurinczuk JJ, Konje JC. Antenatal detection of a single umbilical artery: does it matter? Prenat Diagn. 2003;23(2):117-23. [DOI:10.1002/pd.540] [PMID]
3. Friebe-Hoffmann U, Hiltmann A, Friedl TW, Lato K, Hammer R, Janni W, et al. Prenatally diagnosed single umbilical artery (SUA)-retrospective analysis of 1169 fetuses. Ultraschall der Medizin. 2019;40(02):221-9. [DOI:10.1055/s-0043-123463] [PMID]
4. Hua M, Odibo AO, Macones GA, Roehl KA, Crane JP, Cahill AG. Single umbilical artery and its associated findings. Obstet Gynecol. 2010;115(5):930-4. [DOI:10.1097/AOG.0b013e3181da50ed] [PMID]
5. Tülek F, Kahraman A, Taşkın S, Özkavukçu E, Söylemez F. Determination of risk factors and perinatal outcomes of singleton pregnancies complicated by isolated single umbilical artery in Turkish population. J Turk Ger Gynecol Assoc. 2015;16(1):21-4. [DOI:10.5152/jtgga.2015.15115] [PMID] [PMCID]
6. 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(2):114-7. [DOI:10.1046/j.1469-0705.2000.00055.x] [PMID]
7. Ebbing C, Kessler J, Moster D, Rasmussen S. Single umbilical artery and risk of congenital malformation: population-based study in Norway. Ultrasound Obstet Gynecol. 2020;55(4):510-5. [DOI:10.1002/uog.20359] [PMID]
8. Arcos-Machancoses JV, Marín-Reina P, Romaguera-Salort E, García-Camuñas Y, Pérez-Aytés A, Vento M. Postnatal development of fetuses with a single umbilical artery: differences between malformed and non-malformed infants. World J Pediatr. 2015;11(1):61-6. [DOI:10.1007/s12519-014-0471-3] [PMID]
9. Leung AK, Robson WL. Single umbilical artery. A report of 159 cases. Am J Dis Child. 1989;143(1):108-11. [DOI:10.1001/archpedi.1989.02150130118030] [PMID]
10. Joó JG, Beke A, Papp Z, Rigó J, Papp C. Single umbilical artery in fetopathological investigations. Pathol Res Pract. 2008;204(11):831-6. [DOI:10.1016/j.prp.2008.06.001] [PMID]
11. Gupta A, Shetty D, Philip P. Single umbilical artery with antenatally diagnosed umbilical artery aneurysm in a newborn: a rare case report. Int J Contemp Pediatr. 2017;4(1):254-6. [DOI:10.18203/2349-3291.ijcp20163984]
12. Christensen KM, Heilbrun ME, Patel N, Woodward PJ, Kennedy A. Estimated Fetal Weight and Birth Weight Associated With Isolated Single Umbilical Artery: The University of Utah Experience. Ultrasound Q. 2015;31(1):19-22. [DOI:10.1097/RUQ.0000000000000114] [PMID]
13. Sanjaya INH, Pemayun CIM, Purwanti NWD, Sakuntari MDV, Gianni NPN, Cahyani NLMDM, et al. Single Umbilical Artery (SUA)-prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report. Bali Med J. 2021;10(1):8-10. [DOI:10.15562/bmj.v10i1.2024]
14. Golshahi F, Moradi B, Jabbari F, Ahmadi M. A case of Fraser Syndrome Diagnosed by Ultrasound as a Single Modality; Necessity of Genetic Confirmation? J Obstet Gynecol Cancer Res. 2022;7(6):574-7. [DOI:10.30699/jogcr.7.6.574]
15. Murphy-Kaulbeck L, Dodds L, Joseph KS, Van den Hof M. Single umbilical artery risk factors and pregnancy outcomes. Obstet Gynecol. 2010;116(4):843-50. [DOI:10.1097/AOG.0b013e3181f0bc08] [PMID]