The umbilical cord acts as a link between the fetus and the mother. Inside it are the vessels through which blood enters the placenta. Quite often, various pathologies arise during pregnancy. It happens that a woman has only a single umbilical artery during pregnancy. Let's try to figure out what this means and how it is dangerous for the unborn child.
Structural features
A normal umbilical cord connects the front of the abdominal wall with the placenta (the organ necessary for communication between the mother and the baby). A correctly formed umbilical cord has the following components:
- Two umbilical arteries. They carry blood from the fetus to the placenta.
- Umbilical vein. It works like an artery, only in the opposite direction.
- Urachus. This is the name of the duct connecting the placenta with the baby's bladder.
- Wharton Jelly. It is a connective material that protects the vessels of the umbilical cord.
- The vitelline duct. Connects the intestines of the embryo with the yolk sac (responsible for hematopoiesis and the production of germ cells).
What is the pathology?
The only umbilical artery in the fetus is a pathology in which the structure of the connecting element changes (instead of two, one). This happens quite often: the probability of 1:20 - with a multiple pregnancy and 1: 200 - with a single pregnancy. The risk of developing pathology increases if the expectant mother has diabetes.
One artery may be absent from the very beginning of pregnancy or lose its function at any time (for example, atrophy). The structure of the umbilical cord is clearly visible on ultrasound from twenty weeks. Most often, the only umbilical artery is a single pathology and is not associated with any congenital anomalies (in 75% of cases). However, it is likely that the child has developmental disabilities (25%). Most often, the pathology problem is accompanied by problems with the heart, kidneys, intestines and bones.
Diagnostics
To give birth to a healthy baby, any pregnant woman should be constantly monitored by a doctor and undergo all studies. For any suspicions, you need to carefully examine the unborn child for various malformations and markers of genetic diseases. Do not be afraid of all these studies, because there is nothing more important than health.
The following methods will help with the identification of a single umbilical artery during pregnancy:
- Ultrasound (ultrasound). Before passing, the bladder must be full.
- Dopplerometry. Determines the presence and speed of blood flow.
- Inspection of the gynecologist. Using special tools, the doctor can listen to the baby's heartbeat and, if there is any suspicion, prescribe additional examinations.
If a pathology has been detected, then doctors will offer to undergo karyotyping of the fetus. This procedure involves the collection of amniotic fluid or chorionic villi, as well as a detailed ultrasound and ECHO cardiography.
The only umbilical artery during pregnancy can be seen on an ultrasound scan with a transverse scan, in which the lumen of the vessels is best seen. Diagnosis of pathology is possible from the end of the first trimester. At earlier dates, the umbilical cord is not clearly visualized, so an accurate diagnosis will not work. Difficulties can also arise if a woman has low water, obesity or multiple pregnancy.
Causes
Problems with the vessels of the umbilical cord are not fully understood, but most often they are associated with:
- infectious diseases that the pregnant woman suffered in the first trimester;
- intoxication;
- bad habits (alcohol, smoking, drugs or potent drugs);
- diabetes mellitus;
- radiation exposure, poor ecology, harmful production;
- multiple pregnancy;
- chromosomal abnormalities.
The most dangerous period of pregnancy is 6-9 weeks. At this time, the risk of vascular pathology, placenta and blood flow is increased. Arterial atrophy (one of them ceases to function) can cause: thrombosis, tumors, hematomas or nodes (on one of the arteries). It should be remembered that such conditions occur rather rarely, but require constant observation.
The health status of a woman can also lead to the formation of a single umbilical cord artery during pregnancy. Causes may include: diabetes mellitus, multiple pregnancy, kidney disease, heart disease.
Symptoms
Problems with the umbilical cord do not appear in a woman. They can be detected only during ultrasound or dopplerometry. But there are some symptoms that this pathology can be associated with:
- An increase in the duration of labor with a short umbilical cord. They can last more than 20 hours at the first birth, and more than 15 hours at repeated births.
- Vaginal bleeding, especially if there is a presentation of the umbilical cord (located near the cervix).
- Acute or chronic fetal hypoxia.
You can recognize the lack of oxygen by the following signs:
- Heart palpitations (more than 160 beats per minute). At a later stage, it, on the contrary, can slow down to 120 beats per minute.
- Increased motor activity of the baby. Over time, a slowdown may occur.
- Meconium in the amniotic fluid.
Accompanying illnesses
Women with a single umbilical cord artery often have a second tab, but it just atrophied. Atrophy of the left artery, in contrast to the right, is often combined with abnormalities in the development of the baby. For example, such a pathology may be accompanied by malfunctions of the heart and urogenital system.
Experts noted that the number of cases when one artery was during pregnancy, which ended in a miscarriage due to trisomy, became more frequent. Also, such a trend was noticed in women with dark skin, diabetes. The absence of one of the arteries increases the frequency of perinatal mortality associated with serious malformations by 4 times.
Scientists conducted a study of the dependence of problems with arteries with developmental abnormalities. As a result, it turned out that 15 fruits (out of 30) have health problems. At the same time, 12 of them showed serious pathologies: heart defects, skeleton, diaphragm. In some cases, the manifestation of anomalies is possible after childbirth.
Danger to the fetus
Although it was said above that concomitant pathologies are often found in children with a single umbilical artery, there may not be any consequences. In most cases, the pathology does not have a serious effect on the baby either before or after childbirth. Most often, one artery is able to cope with increased stress. Therefore, if the doctor saw this defect, do not immediately get upset. You just have to go through additional examinations and carefully monitor your condition.
In some cases, there is a risk that the child has developmental abnormalities: chromosomal changes, serious problems with the heart, blood vessels, urinary system, abdominal organs, etc. That is why it is important to detect the presence of other anomalies as early as possible. It should be remembered that syndrome of one artery without other pathologies is not considered a sign of Down syndrome or other malfunctions associated with chromosomes.
If the pathology is accompanied by other defects, there is a high risk to the baby's health. The consequences for a single umbilical artery in the fetus can be as follows:
- frozen pregnancy (long term - intrauterine death);
- developmental delays;
- chronic hypoxia;
- malnutrition.
The correct behavior of the pregnant
Most women after such a diagnosis are at a loss and very worried. They are concerned about the intrauterine development and the future health of the baby. No medication will add the missing artery, but you can minimize the risk of serious consequences.
Therefore, a pregnant woman should:
- less overwork;
- free yourself from hard work;
- prevent constipation;
- observe the daily routine;
- exclude psycho-emotional stress;
- walk and relax more;
- consume more fruits and vegetables.
If you follow these simple recommendations and constantly monitor the condition of the fetus, then there will be no negative consequences. The only umbilical artery during pregnancy in this case may not cause any problems.
Pregnancy Management
As mentioned above, in the presence of pathology, you need to monitor your well-being and the condition of the baby (especially the nature of the movements). Any changes or suspicions should be reported to the physician conducting the pregnancy. He will monitor the state of the woman in dynamics and will appoint a full examination in case of problems.
Additional research will also be needed:
- Ultrasound for a period of 28 weeks;
- screening and full examination at 32 weeks;
- weekly dopplerometry.
If a blood flow disturbance or a delay in the development of the child is suddenly detected, the woman will be offered hospitalization. They will be given maintenance therapy until the baby's condition stabilizes. You should be aware that a child born as a result of such a pregnancy will need careful monitoring (to identify serious abnormalities).
The opinion of gynecologists
At the moment, there is no consensus on how dangerous it is to have a single umbilical cord artery during pregnancy. Reviews of doctors agree only that careful monitoring of a woman and a baby is necessary. Experts believe that the most important research methods are ultrasound and dopplerometry. They are held at certain dates, but if there are problems, examinations are done more often.
In general, gynecologists think so:
- There is some connection between the absence of one artery and the pathologies of the organs and systems of the baby.
- If in addition to this problem there are other malformations, then the risk of chromosomal diseases is high. In this case, it is worth undergoing an amniocentesis or cordocentesis.
- If there is nothing suspicious besides the arteries, then there is a small risk of developmental disorders. To clarify the situation, it is better to go through the procedure of karyotyping.
According to reviews, the only umbilical artery during pregnancy is not too scary, and is not so rare. Many women claim that everything went well and ended with the birth of a healthy baby.
Prevention of Complications
Since the pathology cannot be cured, some preventative measures can be taken. This will reduce the risk of complications and various pathologies.
A woman needs to do the following:
- Prepare in advance for pregnancy (give up alcohol and smoking, eat right, take vitamins, and adjust your health).
- Time to register (up to 12 weeks).
- Regularly visit a doctor conducting a pregnancy, and follow all his recommendations, undergo examinations.
- Eat rationally. You should eat more foods containing fiber (fruits, vegetables, herbs). It is also worth abandoning junk food (from fried, spicy, canned, etc.).
- Undergo dopplerometry, which shows the state of blood flow and any changes in the vessels. With its help, you can see the presence or absence of deviations.
- In time to undergo an ultrasound, at which the doctor will immediately see the growth retardation of the baby, low weight, fetoplacental insufficiency, hypoxia.
- Do not refuse hospitalization with the threat of placental abruption, increasing fetal hypoxia.
- Enough to rest and sleep.
- Avoid physical exertion and various experiences.
The presence of a single umbilical artery during pregnancy is a serious pathology that requires constant monitoring by specialists. After making a diagnosis, a woman should not worry, in most cases, everything ends with the birth of a full-fledged child.