Document Detail


The incidence of isolated single umbilical artery in twins and adverse pregnancy outcomes.
MedLine Citation:
PMID:  23354986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to estimate the incidence of single umbilical artery (SUA) in twin pregnancies and to investigate whether SUA in twin gestations is associated with adverse obstetric outcomes.
METHODS: We performed a retrospective cohort study of consecutive twin pregnancies over 17 years at a tertiary care hospital. Primary exposure was SUA in one or both twins documented at routine second trimester anatomic survey. Adverse obstetric outcomes included small for gestational age (SGA), placental abruption, and preterm birth, evaluated in univariable and multivariable analyses. Analysis was performed both at the pregnancy level and at the fetal level using paired analyses to account for the non-independence of twin pairs.
RESULTS: Of the 2378 twin pregnancies without major anatomic abnormalities, 1.7% (n = 40) had SUA. Only one pregnancy (one monochorionic twin pair) was complicated by both twins having SUA. Twin fetuses with SUA are at increased risk for SGA (aOR = 2.1 (1.2-4.1), p = 0.03) after adjusting for pertinent confounding factors, similar to the findings of previous studies in singleton pregnancies. In addition, twins with SUA may be at increased risk for preterm delivery before 28 weeks compared with twin pregnancies with normal three-vessel umbilical cords (adjusted odds ratio (aOR) 3.2 (1.3-7.89.4), p = 0.01).
CONCLUSIONS: The incidence of SUA in twin gestations in this cohort is significantly less than the recently published data. Similar to reports in singleton gestations, SUA appears to be associated with an increased risk for SGA in twins.
Authors:
Molly J Stout; Anthony O Odibo; Ryan Longman; Anthony L Shanks; Alison G Cahill
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Twin Study     Date:  2013-01-27
Journal Detail:
Title:  Prenatal diagnosis     Volume:  33     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-04     Completed Date:  2013-08-19     Revised Date:  2014-07-14    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  269-72     Citation Subset:  IM    
Copyright Information:
© 2013 John Wiley & Sons, Ltd.
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MeSH Terms
Descriptor/Qualifier:
Abruptio Placentae / epidemiology
Cohort Studies
Female
Humans
Infant, Newborn
Infant, Small for Gestational Age
Pregnancy
Pregnancy Outcome / epidemiology*
Pregnancy Trimester, Second
Pregnancy, Twin
Premature Birth / epidemiology
Retrospective Studies
Single Umbilical Artery / epidemiology*,  ultrasonography
Tertiary Care Centers
Ultrasonography, Prenatal
Grant Support
ID/Acronym/Agency:
5 T32 HD055172-02/HD/NICHD NIH HHS; T32 HD055172/HD/NICHD NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 RR024992/RR/NCRR NIH HHS
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