18 ian. 2010 MORBIDITATEA FETALA ÎN SARCINILE CU ARTERA OMBILICALA UNICA
C Ionescu, Irina Pacu, Diana Gheorghiu, B. Davitoiu, Teodora Vladescu, M. Dimitriu
Clinica de Obstetrica Ginecologie a Spitalului Clinic de Urgenta Sf Pantelimon, Bucuresti
Rezumat
Obiective: obiectivele studiului au fost de a evalua incidenta arterei ombilicale unice, a malformatiilor congenitale asociate, incidenta anomaliilor cromozomiale, vîrsta de gestatie la nastere, calea de nastere, complicatiile sarcinii în cazurile de artera ombilicala unica în vederea stabilirii unei conduite corecte de monitorizare si investigare a sarcinilor la care s-a stabilit ecografic diagnosticul de artera ombilicala unica.
Metoda: 31 de paciente cu artera ombilicala unica diagnosticate ecografic si la care s-au putut urmarii parametrii de mai sus. Evaluarea ecografica s-a realizat folosind ecografe de tip Voluson E8 – General Electric Healthcare transductor de 4-8Mhz si Voluson Pro-General Electric Healthcare transductor de 2-7Mhz.
Rezultate: rata crescuta a malformatiilor congenitale (25,8% fata de 2-3%) cu predominenta celor genitourinare, rata crescuta a anomaliilor cromozomiale (6,47% fata de sub 1%), rata crescuta a retardului de crestere intrauterina (29% fata de 10%).
Concluzii: descoperirea ecografica a existentei unei singure artere ombilicale impune evaluarea riguroasa în sensul identificarii oricaror malformatii fetale asociate, a caror incidenta este evident crescuta. În lipsa asocierii altor anomalii ecografice nu este necesara efectuarea cariotipului fetal. Ecocardiografia fetala este utila în toate cazurile de artera ombilicala unica. Cazurile în care artera ombilicala unica este singura anomalie au evolutie buna, complicatia cea mai frecventa fiind retardul de crestere intrauterina.
Abstract – FETAL MORBIDITY IN PREGNENCIES WITH UNIQUE UMBILICAL ARTERY
Objective: to evaluate the incidence of single umbilical artery, congenital anomalies, cromosomial aberations, gestational age at delivery, the way of delivery in order to establish the correct management to investigate and delivery the pregnancies with single umbilical artery.
Methods: 31 cases with single umbilical artery discovered on ultrasound exam. We collect the informations above from the pacient`s records. Ultrasound exam was made using Voluson E8-General Electric Device Healthcare transductor 4-8mhz and Voluson Pro-General Electric Device Healthcare transductor 2-7 mhz.
Results: increase rate of congenital anomalies (25,8% versus 2-3%) especially genitourinary anomalies, increase rate of cromosomial abnormalities (6,47% versus 1%), increase rate of intrauterine growth retardation (29% versus 10%).
Conclusions: ultrasound diagnosis of single umbilical artery require a proper evaluation of these pregnancies in order to identify any fetal associate malformations which have an increased frecquency. If any other abnormalities can not be identify there is no need for fetal cariotype. Fetal echocardiography is useful in all cases of single umbilical artery. Pregnancies with single umbilical artery and no other abnormalities have good prognosis; the most frequent complication for these cases is intrauterine growth retardation.
Key words : umbilical artery, intrauterine growth retardation, fetal cariotype