Single umbilical artery: what does it mean for the fetus?

Single umbilical artery (SUA ) is the most common anomaly of the umbilical cord which affects between 0.5 and 2.5% of all pregnancies. Aim: Our purpose was to determine whether there was a significant relationship between SUA and other anatomical anomalies. Material and methods: All cases of fetal single umbilical artery identified in our hospital between 2002-2005 were reviewed for other ultrasound detected abnormalities. Results:18 cases of single umbilical artery were diagnosed on the basis of initial sonograms. 17 cases formed the study population (in 10 cases the left artery and in 7 the right artery was absent). In one case we diagnosed an umbilical cord tumor. 33.3% had other anatomical anomalies. The mean of women in the study was 30.5 years, the mean gestational age at examination was 28 weeks. Conclusions: In most cases the SUA occurs to be an isolated anomaly. In cases of SUA, the detailed ultrasound examination should be performed. Left artery absence is more common and also in these cases other anatomical anomalies are more likely to be observed as well. In our study we did not find a correlation between SUA and IUGR

Heart defects and other anomalies in fetuses conceived by assisted reproduction techniques

Aim: The aim of the work was to evaluate the frequency of occurrence of structural, chromosome defects and developmental disorders in fetuses conceived with the help of different assisted reproduction techniques. Material and methods: The research group consisted of 30 patients, aged from 25 to 37, subjected to various techniques of assisted reproduction from 2003 to 2006, who reported for consultation in the referral centre. 13 (43%) of the patients underwent the IVF procedure, 12 (40%) the ICSI procedure, 5 patients underwent interuterine insemination. Ultrasonographic examination with the evaluation of the fetal heart was conducted on average in the 22nd week of gestation. Results: Multiple pregnancies constituted 14 (47%) of the examined pregnancies. In total, fetal anomalies were diagnosed in 3 fetuses (6%). Cardiovascular anomalies occurred in 2 fetuses (atrioventricular septal defect – AVSD and ventricular septal defect – VSD), each with diagnosed trisomy of chromosome pairs 21 and 18 respectively. In one case an anomaly within the urinary system was diagnosed. Conclusions: Multiple pregnancies constituted nearly half of the researched group. Structural defects were diagnosed in 3 (6%) fetuses, which slightly exceeds population risk. A higher anomaly percentage occurred in fetuses from twin pregnancies and in the group after ICSI. In the study the risk is related to the selected group of patient undergoing fetal echocardiography exam. To estimate the risk in the ART group precisely, all pregnancies conceived with implementation of ART should be examined. Multi-centre studies are our future goal