Association Of Single Umbilical Artery With Common And Rare Congenital Malformations

Single umbilical artery (SUA) is the most common abnormality of the umbilical cord. It is associated with an increased incidence of atresia of hollow organs, renal abnormalities, limb reduction defects and spontaneous abortions. The aetiopathogenesis, although unknown, is attributed to vascular disruption. In this study, 15 foetal autopsies with SUA, seen over a one-year period have been reviewed. Apart from the common associations, certain other abnormalities and syndromes, not described previously, have been identified. In addition to the well known multi-system malformations, five cases demonstrated unilateral or bilateral cystic renal dysplasia. Two of these cases had posterior urethral valves, whilst two cases showed additional features of Potter's sequence and one case showed Meckel's syndrome in association with SUA. These anomalies may have been due to obstruction to the urinary outflow, which is known to cause cystic renal dysplasia or may have resulted from ischaemia associated with SUA. The association of SUA with these malformations, previously undocumented warrants further study.