PP-032 Single umbilical artery and supernumerary vessels in the umbilical cord: a review of fetal and pregnancy outcomes

The umbilical cord, comprising three vital blood vessels, serves as the lifeline between mother and fetus, facilitating nutrient exchange and waste removal crucial for fetal development. Prenatal care emphasizes detailed ultrasound examinations of the umbilical cord and postnatal inspections of the placenta and cord to preemptively address potential complications and safeguard maternal and neonatal well-being. Research confirms the correlation between a solitary umbilical artery and adverse perinatal outcomes, including mortality and congenital anomalies. Conversely, the impact of additional vessels remains uncertain, necessitating further investigation. This review is dedicated to enhancing our understanding and refining diagnostic and therapeutic approaches in prenatal healthcare. The objective is to identify knowledge gaps and propose evidence-based solutions to improve care for pregnant women and their unborn babies, aiming for better outcomes in prenatal healthcare practices.

An initial systematic exploration of databases such as Medline, PubMed, and Scopus was undertaken. Publications without a limit in the timeframe were selected. The following set of search terms were included: Pathological number of vessels in the umbilical cord OR Single umbilical artery OR Four vessels umbilical cord AND Perinatal outcomes OR Fetal malformations OR Chromosomal abnormalities (Title/Abstract). Following the removal of duplicate entries, the authors proceeded with a preliminary review of titles and abstracts to evaluate their alignment with the review's objectives. This preliminary phase involved sifting through titles and abstracts, culminating in the selection of 21 pertinent articles. These chosen studies form the bedrock of a narrative review designed to dissect and elucidate the nuanced impacts that anomalies in umbilical cord vessel count exert on perinatal outcomes.

The presence of a single umbilical artery (SUA) in prenatal diagnosis may signify potential risks for fetal anomalies and adverse pregnancy outcomes such as hemodynamic instability, ischemia, and increased likelihood of intrauterine growth restriction (IUGR). Despite SUA is associated with certain complications such as prolonged NICU stay and impaired fetal growth, the significance of these risks may vary depending on the individual case. Additionally, even the presence of supernumerary vessels may be associated with fetal malformations.

Serial fetal evaluations, including ultrasound examinations and Doppler studies, are recommended for detecting anomalies and monitoring fetal growth throughout pregnancy. Despite the generally benign nature of isolated SUA and supernumerary vessels, close monitoring and comprehensive prenatal care are essential to ensure optimal outcomes for both mother and baby. This involves vigilant prenatal screening, postnatal examinations, and appropriate management strategies tailored to each unique case.