Prenatal Detection of Umbilical Cord Vascular Anomalies as a Potential Marker for Fetal Cardiac Defects: Implications for Obstetric Ultrasound Practice

Background & Objective: Prenatal identification of umbilical cord vascular anomalies particularly Single Umbilical Artery (SUA) may serve as an important marker for Congenital Heart Defects (CHD). This study aimed to examine the association between SUA and CHD and evaluate its predictive value in a cohort of infants referred to a cardiac clinic. Materials & Methods: This retrospective case-control study included ۲۶۴ infants (۱۳۲ with CHD and ۱۳۲ healthy controls). Demographic characteristics, prenatal ultrasound findings (including umbilical cord anatomy and fetal echocardiography), and postnatal outcomes were collected. Statistical analyses were performed using multivariate logistic regression and chi-square tests. Results: The prevalence of SUA was significantly higher in the CHD group compared with controls (۱۱.۴% vs. ۶.۱%, P=۰.۰۲۳). The sensitivity of SUA for predicting CHD was ۲۲.۷%, specificity ۸۷.۹%, Positive Predictive Value (PPV) ۶۵.۲%, and Negative Predictive Value (NPV) ۵۳.۲%. Specific cardiac anomalies including Ventricular Septal Defect (VSD), Tetralogy of Fallot (TOF), and Hypoplastic Left Heart Syndrome (HLHS) were significantly associated with SUA (P<۰.۰۰۱ for all). Multivariate analysis identified SUA as an independent risk factor for CHD (OR=۲.۹; ۹۵%CI: ۱.۵-۵.۶; P=۰.۰۰۱). Conclusion: Single Umbilical Artery (SUA) is an independent and significant marker for Congenital Heart Defects. Although its standalone predictive value is limited, the detection of SUA during routine prenatal ultrasound should prompt targeted fetal cardiac evaluation. Integrating SUA with additional risk factors may improve diagnostic accuracy.

کلیدواژه ها:

Single Umbilical Artery (SUA) ، Congenital Heart Defects (CHD) ، Prenatal Ultrasound ، Fetal Echocardiography ، Perinatal Risk Factors