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Single umbilical artery

A single umbilical artery (SUA) is a malformation of the umbilical cord


where only one artery instead of two is present. It may be associated
with other birth defects.

What are the Risk Factors for Single Umbilical Artery?


(Predisposing Factors)

What are the Risk Factors for Short Umbilical Cord? (Predisposing
Factors)
The risk factors for Short Umbilical Cord include:

 Low body mass index (BMI) of mother


 History of smoking during pregnancy
 History of alcohol consumption during pregnancy
 Gestational diabetes
 Chromosomal abnormalities such as Down syndrome
 First pregnancy
 Female fetus
 Preforming early amniocentesis procedures in pregnant women
 Oligohydramnios (decreased fluid in amniotic sac) and
polyhydramnios (excess fluid in amniotic sac)

What are the Causes of Single Umbilical Artery? (Etiology)

 The exact cause of Single Umbilical Artery is unknown


 An abnormal development of the umbilical cord during pregnancy,
may be a possible cause

How is Single Umbilical Artery Diagnosed?


The diagnosis of Single Umbilical Artery may involve:

 Physical examination along with an evaluation of one’s medical


history: The healthcare provider may check for any signs of fetal
distress (such as non-reassuring fetal heart rate)
 Prenatal abdominal ultrasound may reveal the condition and other
associated fetal abnormalities
 A careful examination of the placenta by a pathologist after birth of
the child, to macroscopically (gross visual exam) and
microscopically analyze the placental tissue may help establish a
definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your
healthcare provider may perform additional tests to rule out other clinical
conditions to arrive at a definitive diagnosis.

What are the possible Complications of Single Umbilical


Artery?
Complications due to Single Umbilical Artery may include:

 Premature labor
 Intrauterine growth retardation (IUGR)
 SUA is generally associated with low birth weight
 Increased incidence of neonatal death and stillbirths
 Counseling for the parents who may suffer severe emotional
distress

Infants born from a Single Umbilical Artery pregnancy can have a


number of fetal abnormalities that may include:

 Multiple fingers (polydactyly); fused, webbed fingers (syndactyly)


 Cleft lip
 Cystic hygroma
 Spina bifida
 Ventricular septal defect (VSD)
 The presence of kidney defects, which may remain asymptomatic
until the baby grows. Hence, an ultrasound scan study of the
abdomen of the newborn should be considered

How is Single Umbilical Artery Treated?

 Single Umbilical Artery is a medical emergency and the treatment


is directed at saving the fetus and managing the associated
complications
 A careful and periodic monitoring of the pregnancy is necessary,
since the presence of SUA is considered to be a high-risk
pregnancy
How can Single Umbilical Artery be Prevented?

 A careful examination of the placenta by a pathologist after birth of


the child, to macroscopically (gross visual exam) and
microscopically analyze the placental tissue may help establish a
definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your
healthcare provider may perform additional tests to rule out other clinical
conditions to arrive at a definitive diagnosis.

What is Short Umbilical Cord? (Definition/Background


Information)
 The length of the umbilical cord is important, since it can affect
fetal growth and development. The cord length can also affect the
outcome of the pregnancy
 On an average, the umbilical cord length is between 55 and 60 cm.
A Short Umbilical Cord is usually defined as an umbilical cord that
measures less than 35 cm in length

What are the Signs and Symptoms of Short Umbilical Cord?


The signs and symptoms of Segmental Thinning of Umbilical Cord may
include:

 Decreased blood flow to the fetus resulting in fetal distress


 Non-reassuring fetal heart rates

How is Short Umbilical Cord Diagnosed?


The diagnosis of Short Umbilical Cord may involve:

 Physical examination along with an evaluation of one’s medical


history
 The healthcare provider may check for any signs of fetal distress
(such as non-reassuring fetal heart rate)
 Prenatal ultrasound scan of the developing fetus may reveal Short
Umbilical Cord and abnormal biophysical profile
 A careful examination of the placenta by a pathologist after birth of
the child, to macroscopically (gross visual exam) and
microscopically analyze the placental tissue may help establish a
definitive diagnosis
What are the possible Complications of Short Umbilical Cord?
Complications due to Short Umbilical Cord affect both the mother and
child. These include:

 In the mother:

o Increased incidence of retained placenta


o Prolonged labor
o Inversion of the uterus
o Abruption of placenta causing severe bleeding (during late
pregnancy) affecting the health of both the mother and fetus

 In the baby:

o Cerebral palsy
o Hypoxic ischemic encephalopathy (HIE)
o Intrauterine growth retardation (IUGR)
o Placental disruption, affecting the nutrition of the developing
fetus
 Umbilical cord rupture
 Increased incidence of breech presentation
 Miscarriages and stillbirths

How is Short Umbilical Cord Treated?


There is no specific treatment available for Short Umbilical Cord. The
following treatment strategies can help improve the outcome and overall
health of the newborn.

 An operative vaginal delivery may have to be performed, if the


condition is diagnosed during childbirth. It can help in expediting
the process of childbirth. The operative vaginal delivery may be
performed using techniques such as forceps delivery and delivery
using vacuum extractor
 If a prenatal diagnosis of the condition has been established, then
an elective cesarean section (C-section) delivery may be
considered
 A careful and periodic monitoring of the pregnancy is necessary,
since the presence of Short Umbilical Cord is considered to be a
high-risk pregnancy

The healthcare provider may decide on the course of action on a case-


by-case basis, analyzing all the health issues that are involved.
What is Long Umbilical Cord? (Definition/Background
Information)
 The length of the umbilical cord is important, since it can affect
fetal growth and development. The cord length can also affect the
outcome of the pregnancy
 On an average, the umbilical cord length is between 55 and 60 cm.
A Long Umbilical Cord is usually defined as an umbilical cord that
measures over 80 cm in length

What are the Risk Factors for Long Umbilical Cord?


(Predisposing Factors)
The risk factors for Long Umbilical Cord include:

 Large babies
 High body mass index (BMI) of mother or maternal obesity
 History of cigarette smoking during pregnancy
 Maternal diabetes

What are the Causes of Long Umbilical Cord? (Etiology)

 The exact cause of Long Umbilical Cord is unknown


 Studies have indicated that a Long Cord is common with single
pregnancies than multiple pregnancies (such as twins and triplets)
 This umbilical cord abnormality is associated with a higher
incidence of meconium staining
 Research is currently being performed to identify the relevant
causative factors

What are the Signs and Symptoms of Long Umbilical Cord?


The signs and symptoms of Long Umbilical Cord may include:
 Obstruction of blood flow causing reduced blood flow to the
developing fetus
 Compression of umbilical cord
 There could be an associated polyhydramnios (increased fluid in
the gestational sac)
 Wrapping of the Long Umbilical Cord around the fetal parts

How is Long Umbilical Cord Diagnosed?


The diagnosis of Long Umbilical Cord may involve:

 Physical examination along with an evaluation of one’s medical


history
 Prenatal ultrasound scan of the developing fetus may reveal Long
Umbilical Cord
 A careful examination of the placenta by a pathologist after birth of
the child, to macroscopically (gross visual exam) and
microscopically analyze the placental tissue may help establish a
definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your
healthcare provider may perform additional tests to rule out other clinical
conditions to arrive at a definitive diagnosis.

What are the possible Complications of Long Umbilical Cord?


Complications due to Long Umbilical Cord may include:

 Preterm labor and delivery


 Fetal distress
 Umbilical cord compression can cause abnormal fetal heart rate
 Formation of true knots
 Cerebral palsy
 Umbilical edema, hemorrhage, and thrombosis that can affect the
growing fetus
 A Long Cord can wrap around the fetal neck and choke the
developing fetus; in extreme cases, this may result in stillbirth. This
condition is known as nuchal cord syndrome

How is Long Umbilical Cord Treated?


There is no specific treatment available for Long Umbilical Cord.
However, the following strategies may be useful in obtaining optimal
outcomes:
 If a diagnosis of Long Umbilical Cord is established prenatally,
then an elective cesarean section (C-section) may be undertaken
 If the diagnosis is made during childbirth, then an emergency C-
section may be helpful
 Alternatively, an operative vaginal delivery may have to be
performed, if the condition is diagnosed during childbirth. This
procedure may be performed using techniques such as forceps
delivery and delivery using vacuum extractor
 A careful and periodic monitoring of the pregnancy is necessary,
since the presence of Long Umbilical Cord is considered to be a
high-risk pregnancy
 In case of a fetal distress, an immediate delivery of the baby
should be cons
What are the other Names for this Condition? (Also known

as/Synonyms)

 Cord Knots in Pregnancy


 Placental Knot
 Umbilical Cord Knots

What is True Knot of Umbilical Cord? (Definition/Background


Information)

 An umbilical cord contains a special substance called Wharton’s


jelly, which protects the umbilical cord vessels from damage and
act as a cushion for them. A True Knot of Umbilical Cord is a knot
in the baby’s umbilical cord
 The most common symptom of a True Knot of Umbilical Cord is
decreased fetal activity after 37 weeks. Though, it is not
associated with an increased risk of fetal death, occasionally
complications can occur during labor and delivery

What are the Risk Factors for True Knot of Umbilical Cord?
(Predisposing Factors)
Risk factors associated with True Knots of Umbilical Cord include:

 Multiple pregnancy including twins


 Babies with a long umbilical cord
 Small babies
 Too much amniotic fluid in the womb

What are the Causes of True Knot of Umbilical Cord? (Etiology)

 True Knots of Umbilical Cord mostly form early in the pregnancy


because of the presence of more amniotic fluid and greater fetal
movements
 They usually form when the baby moves around the cord, while
being active in the uterus

What are the Signs and Symptoms of True Knot of Umbilical


Cord?
A decreased fetal activity may be observed with True Knot of Umbilical
Cord after the 37th week

How is True Knot of Umbilical Cord Diagnosed?


The diagnosis of True Knots of Umbilical Cord may include:

 Routine ultrasound examination of the abdomen of the pregnant


woman
 Color Doppler ultrasonography
 Examination of the placenta and umbilical cord at the time of
delivery

What are the possible Complications of True Knot of Umbilical


Cord?
Complications due to True Knot of Umbilical Cord could include:

 Worrying changes in the heart rate of the fetus


 Fetal death and stillbirths

How is True Knot of Umbilical Cord Treated?


True Knots of Umbilical Cord do not require specific treatment.

 In a majority of the cases, there are no complications. But, if the


knot gets tight while the baby is passing through the birth canal,
fetal death might occur
 Cesarean section can be done in cases of fetal compromise. In
fetal compromise, the oxygen and nutrition supply is disrupted
enough to affect the well-being of the unborn child

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