Obstetrics & Gynecology>>>>>Maternal-Fetal Physiology and Placentation
Question 4#

A 25-year-old P0 presents for routine anatomy ultrasound at 20 weeks’ gestation. The only significant finding at the time of ultrasound is the presence of a single umbilical artery (SUA). Targeted ultrasound does not demonstrate any other abnormalities. The patient asks you if this SUA will impact how you manage the rest of her pregnancy.

What should you tell her?

a. Her pregnancy will not be managed any differently due to the isolated finding of SUA
b. The next step in her management should be genetic amniocentesis
c. She will require periodic assessments of fetal growth
d. She should be delivered by 39 weeks’ gestation at the latest
e. She will require delivery by cesarean

Correct Answer is C

Comment:

The finding of SUA in the absence of other abnormalities does not require karyotype evaluation, early delivery, or delivery by cesarean. The timing and mode of delivery may be determined by routine obstetric indications. Patients with a fetus with SUA should undergo periodic growth assessments with ultrasound, as there is an increased risk of growth restriction in these fetuses.