Does single umbilical artery syndrome affect the fetuss health or the birth process

The discovery of a single umbilical artery during pregnancy can raise concerns and questions for many mothers, especially when they first hear this diagnosis during an ultrasound examination. Does having one umbilical artery instead of two mean there is a problem with the fetus’s growth or health? Can the pregnancy progress normally, with the baby being born healthy and without complications? In this article on Dalili Medical, we will explore what a single umbilical artery is, its possible causes, how it may affect the fetus, and when additional tests or close monitoring may be necessary to ensure the health and well-being of both the mother and the baby.

What Is Single Umbilical Artery Syndrome?

A Single Umbilical Artery (SUA) is a condition in which the umbilical cord contains only one artery and one vein, instead of the normal structure, which consists of two arteries and one vein.

This condition may be detected during pregnancy ultrasound examinations. However, it does not necessarily indicate a health problem in the fetus, particularly when it is isolated and not associated with any other congenital abnormalities.

During Which Month of Pregnancy Can a Single Umbilical Artery Be Detected?

A single umbilical artery can sometimes be detected during the first trimester of pregnancy. However, it is most commonly identified during the detailed anatomy scan in the middle of pregnancy, usually between the 18th and 22nd weeks.

Can Two Umbilical Arteries Appear on an Early Ultrasound Scan, but Only One Appear Later?

The visibility of blood vessels on ultrasound images may vary depending on the gestational age, the fetus’s position, and the quality of the examination. Therefore, if an early scan shows two arteries while a later scan appears to show only one, the doctor may recommend repeating the examination or using Doppler ultrasound to confirm the number of blood vessels in the umbilical cord.

Does a Single Umbilical Artery Affect the Amount of Amniotic Fluid?

The presence of a single umbilical artery does not necessarily cause changes in the amount of amniotic fluid surrounding the fetus. However, if the condition is associated with kidney abnormalities or fetal growth problems, the amount of amniotic fluid may be affected. For this reason, doctors monitor amniotic fluid levels during follow-up examinations.

Does a Single Umbilical Artery Affect Fetal Movement?

When a single umbilical artery is isolated and not associated with other problems, it does not usually directly affect fetal movement. However, a noticeable decrease in fetal movement compared with the baby’s usual pattern requires immediate contact with the maternity unit for medical assessment. It is important not to assume that the single umbilical artery is the cause.

Can Fetal Growth Stop Because of a Single Umbilical Artery?

The presence of a single umbilical artery does not mean that fetal growth will stop or that the baby will necessarily experience growth problems. Most isolated cases have reassuring outcomes, particularly when no other congenital abnormalities are present.

Does Every Fetus with a Single Umbilical Artery Need a Fetal Echocardiogram?

Not every fetus with a single umbilical artery necessarily requires a specialized fetal echocardiogram. The fetal heart should first be carefully assessed during the detailed anatomy scan. The doctor may recommend a fetal echocardiogram if there are findings that warrant further investigation or if the heart cannot be adequately evaluated during the examination.

Does a Fetus with a Single Umbilical Artery Need Genetic Testing?

An isolated single umbilical artery does not automatically require genetic testing. The decision depends on the detailed ultrasound findings, the results of previous chromosomal screening tests, and the presence of any additional markers or congenital abnormalities that may require further evaluation. The doctor will determine the appropriate tests based on each individual case.

Can a Single Umbilical Artery Be Confirmed Using a Standard Ultrasound Scan Alone?

A single umbilical artery may be suspected during a standard ultrasound examination, but confirming the number of blood vessels can sometimes be difficult. Therefore, color Doppler ultrasound may help determine the number of arteries in the umbilical cord more accurately, particularly when the images are unclear.

Does the Fetus Need a Doppler Ultrasound at Every Doctor’s Visit?

Not every fetus with a single umbilical artery requires a Doppler ultrasound at every prenatal visit. The doctor determines whether Doppler assessment is necessary based on fetal growth, previous examination results, and blood flow evaluation when indicated. In cases of isolated single umbilical artery with normal fetal growth, Doppler ultrasound is not necessarily required at every visit.

Should Delivery Take Place at a Specialized Hospital if the Fetus Has a Single Umbilical Artery?

If the single umbilical artery is isolated, the examination results are reassuring, and fetal growth is normal, delivery at a standard maternity hospital may be appropriate, depending on the doctor’s assessment.

However, if the condition is associated with other congenital abnormalities, fetal growth restriction, or additional health problems, the doctor may recommend planning delivery at a medical center equipped to provide the newborn with the care required for their specific needs.

Does a Newborn Need Admission to the Neonatal Intensive Care Unit (NICU) Because of a Single Umbilical Artery?

A newborn does not need NICU admission solely because of a single umbilical artery, particularly if the baby is born at term and is medically stable. The need for specialized care depends on several factors, including gestational age at birth, birth weight, the baby’s overall development, and the presence of any health problems requiring additional care.

Can a Single Umbilical Artery Affect the Child’s Future Fertility?

There is insufficient evidence to suggest that an isolated single umbilical artery, by itself, affects future fertility. The child’s health depends on whether any associated health problems or congenital abnormalities are present, rather than solely on the number of arteries in the umbilical cord.

Can an Ultrasound Result Be Inaccurate When Diagnosing a Single Umbilical Artery?

Yes. In some cases, determining the exact number of blood vessels in the umbilical cord may be difficult because of the fetus’s position, unclear images, or limitations of the examination. If the findings are inconclusive, the doctor may recommend repeating the ultrasound or using color Doppler ultrasound to confirm the diagnosis.

Can a Second Umbilical Artery Develop if the Mother’s Nutrition Improves During Pregnancy?

No. Good nutrition cannot cause a second umbilical artery to develop if the condition results from a variation in blood vessel formation during fetal development. However, following a balanced diet and adhering to medical advice help support maternal and fetal health, although they do not change the number of blood vessels in the umbilical cord.

Is a Single Umbilical Artery a Serious Condition?

Not necessarily. If the single umbilical artery is isolated and the detailed fetal anatomy scan shows normal findings, the condition is generally reassuring. However, monitoring fetal growth remains important throughout pregnancy.

Does the Presence of a Single Umbilical Artery Mean the Fetus Has Congenital Abnormalities?

No. The presence of a single umbilical artery does not necessarily mean that the fetus has congenital abnormalities. This condition may occur without any other defects. Nevertheless, a detailed ultrasound examination is recommended to assess the development and health of the fetal organs.

Is a Single Umbilical Artery Associated with Down Syndrome?

The presence of a single umbilical artery does not mean that the fetus has Down syndrome. When the condition is isolated, additional chromosomal testing is not generally recommended solely because of this finding, in accordance with maternal-fetal medicine guidelines.

Does a Single Umbilical Artery Affect Fetal Weight?

A single umbilical artery may be associated with an increased likelihood of low birth weight or fetal growth restriction. Therefore, an ultrasound examination during the third trimester is recommended to assess fetal growth and estimate the baby’s weight.

Does a Single Umbilical Artery Affect the Fetal Heart?

Congenital heart defects may be associated with this condition in some fetuses, but they do not necessarily occur. The fetal heart should be assessed during the detailed anatomy scan. The doctor may recommend a specialized fetal echocardiogram if the images are unclear or other findings warrant further evaluation.

Does a Single Umbilical Artery Affect the Fetal Kidneys?

In some cases, a single umbilical artery may be associated with differences in the development of the kidneys or urinary tract. Therefore, the doctor examines the fetal kidneys and bladder using ultrasound to assess their structure and development.

Can a Single Umbilical Artery Be Treated with Medication?

There is no medication that can restore or create a second umbilical artery. Medical care focuses on monitoring fetal growth, assessing the development of the fetal organs, and managing any associated health problems if they arise.

Does a Single Umbilical Artery Require Complete Bed Rest and Avoiding Physical Activity?

The presence of a single umbilical artery alone does not require complete bed rest or avoiding physical activity. Pregnant women can generally continue their usual daily activities unless their doctor recommends activity restrictions for other medical reasons.

Does a Single Umbilical Artery Require a Cesarean Section?

No. A single umbilical artery alone does not require a cesarean section. The mode of delivery is determined by the condition of the mother and fetus, the baby’s position, and any other medical factors that may affect the safety of delivery.

Can a Single Umbilical Artery Recur in a Subsequent Pregnancy?

Having a single umbilical artery in a previous pregnancy does not necessarily mean that the condition will recur in a subsequent pregnancy. It is advisable to inform the doctor about the previous pregnancy history to discuss appropriate monitoring during the new pregnancy.

Does the Baby Need Medical Tests After Birth?

If the condition is isolated and prenatal examination results are reassuring, the pediatrician will determine whether additional tests are necessary based on the clinical examination and medical history. If heart or kidney abnormalities were identified during pregnancy, appropriate tests and follow-up care can be arranged after birth.

Can a Child with a Single Umbilical Artery Live a Normal Life?

Yes. Many children with an isolated single umbilical artery grow and develop normally and enjoy good health. However, the prognosis depends on the examination findings and whether any associated health problems are present.

Can Psychological Stress Cause a Single Umbilical Artery?

There is no scientific evidence establishing psychological stress as a direct cause of a single umbilical artery. Therefore, pregnant women should not blame themselves or feel responsible for this condition because of the psychological stress they experienced during pregnancy.
Can You Exercise During Pregnancy with a Single Umbilical Artery?

In most cases, pregnant women can continue their usual physical activities if there are no other medical contraindications. However, it is advisable to consult a doctor to determine the type and intensity of exercise that are appropriate for the pregnancy and the examination findings.

Does a Pregnant Woman Need to Take Additional Vitamin Supplements?

The presence of a single umbilical artery, by itself, does not require additional doses of vitamins or dietary supplements. The doctor determines the mother’s nutritional needs based on her health condition, laboratory results, and medical recommendations. Additional doses should be avoided without medical advice.

What Are the Symptoms of a Single Umbilical Artery?

A single umbilical artery is a condition that may not cause any noticeable symptoms in the mother or fetus. It is usually discovered during a pregnancy ultrasound examination.

First: Symptoms in the Mother

A single umbilical artery generally does not cause symptoms in the mother.
- Pregnancy may progress normally, and the condition may be discovered incidentally during an ultrasound scan.
- The condition does not usually cause vaginal bleeding, abdominal cramps, or abdominal tightness.
Second: Signs That May Appear in the Fetus

A single umbilical artery does not necessarily cause visible problems. However, in some cases, the doctor may identify the following findings:
- Slower fetal growth: The fetus may be smaller than expected for the gestational age.
- Associated congenital abnormalities: These may include certain heart defects or differences in the development of the kidneys and urinary tract.
- Normal growth without other problems: This is common when the single umbilical artery is isolated.
Third: How Is a Single Umbilical Artery Detected?

The condition is usually identified during a pregnancy ultrasound examination, in which the doctor examines the blood vessels in the umbilical cord.

A normal umbilical cord contains two arteries and one vein, whereas an umbilical cord with a single umbilical artery contains only one artery and one vein.

Important note: If you experience pain on either side of your lower abdomen or in the lower abdomen generally, do not assume that it is caused by a single umbilical artery. If the pain is severe, persistent, or accompanied by bleeding, seek urgent medical evaluation.

What Are the Types of Single Umbilical Artery?

Clinically, a single umbilical artery is classified into two main categories based on whether the fetus has any associated abnormalities or other medical problems.

1. Isolated Single Umbilical Artery

Outcomes are generally reassuring

This refers to the presence of one umbilical artery instead of two, without any other congenital abnormalities being identified in the available examinations.

Its characteristics include:
- Fetal growth may be normal.
- The results are generally reassuring if the detailed anatomy scan is normal.
- The doctor may recommend ultrasound examinations to monitor fetal growth throughout pregnancy.
2. Non-Isolated Single Umbilical Artery

This refers to the presence of a single umbilical artery alongside one or more additional fetal abnormalities, which may include:
- Certain congenital heart defects.
- Differences in the development of the kidneys or urinary tract.
- Other congenital abnormalities affecting various organs.
- Certain chromosomal or genetic disorders in some cases.
The presence of a single umbilical artery does not necessarily mean that these problems exist. However, a detailed examination is needed to assess the fetal organs and determine whether additional testing is necessary.

3. Are There Other Classifications of Single Umbilical Artery?

Yes. Specialized anatomical classifications are based on the origin of the remaining artery and the structure of the blood vessels. However, these classifications are generally less important in routine pregnancy monitoring than determining whether the condition is isolated or associated with other abnormalities.

Diagnosis and Treatment of a Single Umbilical Artery During Pregnancy

First: How Is a Single Umbilical Artery Diagnosed?

A single umbilical artery (SUA) is usually diagnosed during pregnancy using ultrasound. This examination helps determine the number of blood vessels in the umbilical cord, assess the fetal organs, and monitor fetal growth.

1. Standard Ultrasound

The doctor examines the umbilical cord to determine the number of blood vessels it contains. A single umbilical artery can usually be detected during an ultrasound examination in the second trimester.

2. Color Doppler Ultrasound

Color Doppler ultrasound helps identify the number of arteries surrounding the fetal bladder. It can also assess blood flow through the blood vessels when necessary.

3. Detailed Fetal Anatomy Scan

This examination is an important step after a single umbilical artery is detected. The doctor assesses the fetal organs, including:
- The heart: To identify potential congenital heart defects.
- The kidneys and bladder: To assess the urinary system.
- The spine and other organs: To evaluate their development and check for abnormalities.
Are Blood Tests Needed to Diagnose a Single Umbilical Artery?

No. Blood tests alone cannot diagnose a single umbilical artery. The diagnosis is based primarily on ultrasound findings.

If the condition is isolated and the detailed anatomy scan is normal, additional chromosomal testing is generally not recommended solely because of the single umbilical artery, in accordance with maternal-fetal medicine guidelines.

The doctor may recommend an ultrasound examination during the third trimester to assess fetal growth and determine whether additional monitoring is necessary based on the findings.

Second: Are There Medications to Treat a Single Umbilical Artery?

There is no medication that can recreate the second umbilical artery or directly treat the condition itself.

The medical management plan depends on the examination findings and the fetus’s condition:
- If the condition is isolated and fetal growth is normal: Medical follow-up and growth assessments according to the doctor’s recommendations are the main priorities.
- If fetal growth is below expectations: The doctor determines which additional examinations are necessary and may use Doppler ultrasound to monitor blood flow and assess fetal well-being.
- If associated congenital abnormalities are present: Appropriate care is determined according to the type and severity of the problem.
What If the Fetus Has Poor Growth?

If an ultrasound shows that the fetus is smaller than expected for the gestational age, the doctor may recommend the following:
- Doppler examinations to monitor blood flow.
- Monitoring fetal growth and heart rate according to the individual case.
- Assessing whether delivery should take place at an appropriate time if concerning findings emerge.
A cesarean section is not performed solely because of a single umbilical artery. The mode of delivery depends on the condition of the mother and fetus and any associated medical factors.

Aspirin, blood thinners, or other medications should not be taken to treat a single umbilical artery without medical advice, as these medications cannot recreate the missing artery.

Third: Can a Single Umbilical Artery Be Treated with Surgery?

There is no established surgical procedure to recreate the second umbilical artery during pregnancy, and a single umbilical artery alone does not require surgery.

Medical care focuses on monitoring fetal growth, assessing the development of the fetal organs, and identifying any potential complications as early as possible.

What Medical Procedures Might the Fetus Need?

Medical procedure	When is it used?
Detailed ultrasound scan	To assess the fetal organs after the condition is detected.
Vascular Doppler ultrasound	When impaired blood flow or fetal growth restriction is suspected.
Ultrasound monitoring of fetal growth	To assess estimated fetal weight and growth rate throughout pregnancy.
Genetic testing or amniocentesis	When other findings warrant further evaluation and discussion with a maternal-fetal medicine specialist.
Determining the timing and mode of delivery	When medical factors affecting the safety of the mother or fetus require consideration.

These procedures do not recreate the missing artery. Instead, they help assess fetal health and manage any associated problems when necessary.

Can Surgery Be Performed on the Fetus?

Surgery is not performed to add a second umbilical artery or replace the existing artery. Other fetal surgeries are used for specific medical conditions, but they are not considered treatments for the single umbilical artery itself.

Prevention and Management Tips for a Single Umbilical Artery During Pregnancy

It is important to understand that a single umbilical artery cannot be prevented in most cases because its exact cause is often unknown. However, regular prenatal care helps assess fetal health, identify potential complications early, and ensure that appropriate measures are taken when necessary.

First: Medical Monitoring During Pregnancy

Regular medical follow-up is one of the most important steps in managing a single umbilical artery. It includes the following:

Detailed ultrasound scan: To examine the fetal organs, particularly the heart and kidneys, and check for associated congenital abnormalities.
Monitoring fetal growth: An ultrasound examination is generally recommended during the third trimester to assess fetal growth and estimate fetal weight.
Doppler ultrasound when needed: The doctor may request this examination if fetal growth restriction or impaired blood flow is suspected. However, it is not equally necessary in every case.
Attending scheduled prenatal appointments: Follow the recommendations of your obstetrician or maternal-fetal medicine specialist according to the examination findings.

Second: Nutrition and a Healthy Lifestyle

Following a healthy lifestyle supports the overall health of both the mother and fetus. However, it cannot recreate the second umbilical artery or directly prevent the condition.

Eat a balanced diet containing protein, vegetables, fruits, and iron-rich foods.
Drink adequate amounts of water.
Take folic acid and prenatal vitamins according to your doctor’s recommendations.
Avoid smoking and exposure to secondhand smoke, and abstain from alcohol.
Maintain appropriate blood sugar and blood pressure levels if you have diabetes or hypertension.
Continue your usual daily activities unless medical contraindications exist, as a single umbilical artery alone does not require complete bed rest.

Third: Medications That Require Caution

There is no specific medication to treat a single umbilical artery or recreate the missing artery. Therefore, it is important to follow these precautions:

Do not start taking aspirin or blood thinners on your own.
Do not use medications marketed to improve blood circulation or promote fetal growth without a prescription.
Do not take additional doses of vitamins or dietary supplements in an attempt to treat a single umbilical artery.
If fetal growth restriction develops, the doctor will determine the appropriate monitoring and management plan based on the underlying cause and examination findings.

This does not mean that you should stop any medication already prescribed to you. Instead, consult your doctor before changing any treatment, as it may have other medical indications.

Fourth: When Should You See a Doctor?

Attend regular prenatal appointments to monitor fetal growth and ultrasound findings. Seek urgent medical assessment if you experience vaginal bleeding, severe or persistent pain, or a noticeable decrease in fetal movement after a regular movement pattern has been established, following the monitoring guidance provided by your doctor.

Fifth: Can the Pregnancy Progress Normally?

Yes. Many cases of isolated single umbilical artery progress normally, and the babies are born healthy. The monitoring plan depends on the detailed ultrasound findings, the fetus’s growth rate, and whether any associated health problems are present.

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