Analysis Of The Relationship Between Fetal Single Umbilical Artery And Chromosomal Abnormalities And Pregnancy Outcome

OBJECTIVE:To analysis the fetal malformation of single umbilical artery and investigate the relationship between single umbilical artery and fetal chromosomal abnormality and pregnancy outcome,to provide clinical recommendations for genetic counseling and eugenics.METHOD:A retrospective analysis for 82 cases of pregnant women with single umbilical artery who have prenatal diagnosis in the center of prenatal diagnosis in our hospital from January 2011 to January 2015 were included in the study group.All the cases were divided into simple single umbilical artery group and single umbilical artery combined malformation group according to the single umbilical artery and other abnormalities. Among them,49 cases were simple single umbilical artery group,33 cases of single umbilical artery combined malformation group. In the same period,50 cases of pregnant women who were randomly selected from the normal umbilical cord structure and missed serological screening time or the elderly in our department were included in the control group. To record single umbilical artery of fetal malformation, compare and analyze the results of prenatal diagnosis and pregnancy outcome, and follow up the growth and development of infants in the neonatal period.RESULT:The incidence of fetal malformation is 40.24% in single umbilical artery, the most common is cardiovascular malformations, followed by malformations are the central nervous system malformation and urinary system malformation. The incidence of fetal chromosomal abnormalities is 10.98% in the single umbilical artery group, no abnormal karyotype was found in the non-single umbilical artery group. The single umbilical artery combined malformation group compare respectively with non-single umbilical artery group and the simple single umbilical artery group, the difference of chromosome abnormality rate was statistically significant (P< 0.05); simple single umbilical artery group compare with non-single umbilical artery group, the difference of chromosome abnormality rate had no statistical significance (P >0.05). Simple single umbilical artery group compare with non-single umbilical artery group, the difference of cesarean section rate was statistically significant (P< 0.05), the rate of preterm birth、FGR rate、neonatal gestational age、neonatal birth weight、low birth weight rate and neonatal with deformity rate showed no statistical significance (P> 0.05).The single umbilical artery combined malformation group compare with non-single umbilical artery group, the difference of FGR rate、neonatal birth weight、low birth weight rate and neonatal malformation rate was statistically significant (P< 0.05), the difference of premature delivery rate、cesarean section rate and neonatal gestational age was not statistically significant. In single umbilical artery combined malformation group, there were 6 cases of growth and development abnormalities in infancy,8 cases were normal. No growth abnormalities were found in the newborn infants with single umbilical artery group and non-single umbilical artery group.Single umbilical artery combined with malformation may affect the growth and development of neonatal infants, they need to be long-term followed up after the birth of newborn.CONCLUSION:(1)The single umbilical artery fetus is prone to many kinds of structural abnormalities, the top three are cardiovascular system、 central nervous system and urinary system abnormalities, the fetus of single umbilical artery need to do systematic ultrasound examination.(2) Fetal single umbilical artery associate with chromosomal abnormalities, when the single umbilical artery combined malformations, the incidence of chromosomal abnormalities rate increase, it is necessary to do prenatal diagnosis of fetal chromosome. (3)Most of the single umbilical artery of the fetus pregnancy outcome is good, the incidence of adverse pregnancy outcome is high in single umbilical artery combined with malformation.