Dr. Deepti Verma
Fetal Medicine
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Patient's Query
Hi doctor,
A single umbilical artery is observed in 22nd week L2 pregnancy ultrasound. All other parameters are fine in relation to the growth of the fetus. I want to know how to deal with this. Can we go for amniocentesis or chromosome study? I also have a low-lying placenta with 5.9 inches distance from the os. I am so confused. I have seen a child, who was born with intestine issues. The child's stomach was stitched to the mother's skin after birth. Please help.
Hi,
Welcome to icliniq.com.
I have gone through your question and understand the concerns. A single umbilical artery can be associated with chromosomal anomalies, structural anomalies, or can be unassociated with any other anomaly. Since the previous child also had anterior abdominal wall defect, so there is a risk of an anomaly in this fetus. I will suggest getting an amniocentesis done to rule out any chromosomal anomalies and a fetal echocardiogram done at 22 to 24 weeks scan to rule out any congenital heart disease.
Hope you found the answer helpful. Regards.
Patient's Query
Hi doctor,
Thanks for your reply. There is a little confusion in this statement "since the previous child also had anterior abdominal wall defect, so there is a risk of an anomaly in this fetus," this is my elder brother's child. I have a 4 year old healthy daughter. My doctor told me that there is no need for any test further as the baby is healthy till date. I feel that further monitoring is needed, but they did not observe any physical abnormality in the fetus. Please help.
Hi,
Welcome back to icliniq.com.
I am sorry for the misinterpretation. The risk of congenital anomalies in the fetus in case of a single umbilical artery is 1%. Hence, amniocentesis is justified to confirm the fetal karyotype in this case. Moreover, a single umbilical artery is associated with minor congenital anomalies, which are not detected by ultrasound and are detected at birth. So, in my opinion, amniocentesis is advisable. If normal fetal karyotype is detected, then fetal echo at 24 weeks and regular follow-up should be done.
Hope you found the answer helpful. Regards.
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