גרסה באנגלית
ממצא באולטרהסאונד/ סקירת מערכות שליש שני.
על פי הנחיית האיגוד המקצועי, אם מופיע כממצא בודד אינו אינדיקציה להפניה לייעוץ גנטי. כאשר מלווה על ידי ממצאים נוספים, כן יש המלצה לכך.
לגישתי, לאור שכיחות עולה של הפרעה בגדילה בהריון עודף, יש לשקול יילוד אלקטיבי סביב שבוע 40.
SINGLE UMBILICAL ARTERY (SUA) The incidence of SUA (Fig. 24.7) in uncomplicated pregnancy is 0.5–2.5% reaching 5% in twin pregnancies.18 The most important clinical implication of SUA is its association with a huge number of syndromes and fetal structural and chromosomal abnormalities,19– 21 with IUGR,18 unexplained fetal death, placental abnormalities and abnormalities of the umbilical cord insertion.19 Even in the absence of congenital or chromosomal abnormalities fetuses with SUA have a higher perinatal mortality rate.19 Prenatal sonography can identify only 37% of fetal anomalies associated with SUA21 and this is important during counselling. Fetal karyotyping should be offered when additional anomalies are present. Moreover, fetal growth should be monitored and pediatricians have to be informed in order to search for Figure 24.7: Single umbilical artery The diagnosis is quite easy to carry out. Usually the single artery is larger due to an adaptational dilatation of the single artery and sometimes the diameter may reach that of the umbilical vein.22 It is important to look at different parts along the umbilical cord to rule out fused arteries. Color Doppler can be used to visualize the single artery as the artery courses around the bladder. Usually the left one is absent
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