The umbilical cord is the baby's lifeline during pregnancy. Normally, it contains two arteries and one vein. A single umbilical artery (SUA) means one of these arteries is absent, leaving a single artery in umbilical cord. It is also called a two-vessel cord.
Finding SUA on an ultrasound can understandably cause concern. However, it does not automatically mean that something is wrong with the baby. In many pregnancies, particularly when SUA is an isolated finding, the baby develops normally. Doctors may recommend additional scans to check fetal anatomy and growth, depending on the overall ultrasound findings.
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Normally, the umbilical cord contains two arteries that carry blood from the fetus to the placenta and one vein that carries blood from the placenta back to the fetus. When one of these arteries is missing, only one umbilical artery and one vein are present, a condition known as a single umbilical artery.
It means that a single artery in umbilical cord occurs when one of the normally existing two arteries does not develop or no longer exists. This condition is also known as a two-vessel cord.
A normal umbilical cord has two arteries and one vein, commonly described as the umbilical cord two arteries and one vein structure. These blood vessels are protected by a jelly-like substance called Wharton’s jelly. The two arteries carry deoxygenated blood and waste products from the fetus to the placenta, while the vein carries oxygen and nutrients from the placenta to the fetus.
In the case of a Single Umbilical Artery (SUA), one of the two arteries is missing. As a result, the umbilical cord contains one artery and one vein. The remaining artery continues to carry blood between the fetus and placenta, allowing the umbilical cord to perform its essential function.
The exact cause of single umbilical artery is not always known. It may occur because one artery fails to develop normally, becomes narrowed or disappears during early fetal development, or because an earlier single vessel persists.
Importantly, SUA is generally not caused by something a mother ate, did, or failed to do during pregnancy. Routine diet, exercise, stress, or everyday activities are not considered established causes.
SUA is relatively prevalent among umbilical cord variations. According to ISUOG, SUA occurs in about 0.5% of singleton pregnancies; however, the incidence rates may differ depending on specific population and criteria for SUA diagnosis. Most commonly, SUA is detected during the second-trimester ultrasound examination.
Single umbilical artery is normally detected with prenatal ultrasound, especially during the detailed anatomy scan. Ultrasound examination can evaluate the number of vessels in the cord. In addition, colour Doppler can be applied to confirm the diagnosis, including the study of vessels around the baby's bladder.
Is single umbilical artery detected with ultrasound? Yes, the answer to this question is yes. Ultrasonography is the only way to detect SUA.
The significance of SUA depends largely on whether it is isolated or occurs alongside other findings.
Isolated SUA means no other structural abnormalities are identified. Many such pregnancies progress normally, although fetal growth may be monitored more closely.
Non-isolated SUA occurs when other abnormalities are also detected. SUA has been associated with certain heart, kidney and other structural abnormalities. Some cases may also be associated with chromosomal conditions. These associations do not mean that every baby with SUA will develop a problem.
The existence of isolated SUA doesn’t always imply that the baby will have some issues. The general prognosis will be determined by the results of a thorough ultrasound and whether the development of the fetus is normal.
When other abnormalities are detected, doctors might order more tests to be done.
In the presence of SUA, there might be congenital anomalies, especially the ones associated with the cardiovascular system and kidneys. However, the presence of SUA itself does not indicate any birth defects. The thorough ultrasound scan will help the doctors examine for the possible accompanying abnormalities.
Every pregnancy does not necessarily need the same tests. In accordance with findings, your doctor might recommend:
● Ultrasound examination of fetal anatomy
● Fetal echocardiography if needed
● Growth scans
● Doppler study as indicated
● Genetic screening or diagnostic testing when other abnormalities are present
ISUOG recommends detailed ultrasound assessment after SUA is identified, with additional investigations guided by the results.
There is no procedure during pregnancy to replace the missing artery. Therefore, single umbilical artery treatment generally means monitoring rather than treating the cord itself.
If SUA is isolated, treatment may not be required. Doctors may monitor fetal growth and wellbeing through follow-up scans. If another condition or growth problem develops, its management will depend on the specific diagnosis.
Does Single Umbilical Artery Affect Baby's Growth?
Some studies have associated SUA with fetal growth restriction, which is why growth may be monitored during later pregnancy. However, many babies with isolated SUA grow normally. Serial ultrasound examinations can help doctors track growth and identify any concerns early.
Yes. Many pregnancies with isolated SUA progress normally. Regular prenatal appointments and recommended ultrasound monitoring are important. The outlook is influenced more by associated findings and fetal growth than by the cord finding alone.
Speak with your doctor if SUA has been identified and you have questions about the finding or recommended tests. Contact your maternity team promptly for reduced fetal movements, concerning pregnancy symptoms, or if additional abnormalities have been reported.
Cloudnine offers coordinated obstetric and fetal evaluations for pregnant women who have been diagnosed with SUA using an ultrasound. In individual cases, it may involve an extensive ultrasound study, growth studies, and consultation with specialists to ensure that the patient knows how SUA affects her pregnancy rather than thinking that every SUA pregnancy is risky.
A one artery in umbilical cord finding can sound alarming, but it does not automatically indicate an unhealthy pregnancy. When SUA is isolated and the baby's anatomy and growth are normal, the outlook is often reassuring. Appropriate ultrasound monitoring and personalised obstetric care help identify any concerns while avoiding unnecessary anxiety.
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No. SUA does not mean that a baby has Down syndrome. Additional testing depends on the overall ultrasound and pregnancy findings.
Not necessarily. Isolated SUA may require additional monitoring, while SUA with other abnormalities may need more specialised care.
Yes. Many babies with an isolated SUA are born healthy and develop normally.
The absent artery does not normally return. The focus is on monitoring the baby's growth and checking for associated abnormalities.
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