Screening infants with an isolated single umbilical artery for renal anomalies: nonsense?

BACKGROUND

Presently there is no consensus regarding the extent of workup required in newborns who present with an isolated single umbilical artery (SUA). Because of the association with silent renal anomalies, some studies advise to perform renal ultrasonography in infants born with an isolated SUA.

AIMS: To decide whether screening (performing a renal ultrasound and in case of abnormalities on the ultrasound performing a micturating cystourethrogram) infants with an isolated SUA is justified by evaluating the prevalence of clinically relevant renal abnormalities.

STUDY

DESIGN

Retrospective descriptive study.

SUBJECTS: Live-born infants with SUA detected by physical examination born between January 1st, 1997 and February 1st, 2005, in a tertiary care university hospital.

OUTCOME MEASURES: Renal anomalies detected by renal ultrasonography and a micturating cystourethrogram in infants with abnormalities on renal ultrasound.

RESULTS

We included 52 live-born infants with an isolated SUA. Renal ultrasonography was performed in 92.3% of these 52 infants. In this group, abnormalities were found in 5 infants (10.4 %) on renal ultrasound. A relative subpelvine stenosis was detected in 1 infant, the other abnormalities on renal ultrasound were mild hydronephrosis without further consequences.

CONCLUSION

Our data suggest that it is not necessary to screen for renal anomalies in infants with a single umbilical artery without other anomalies seen at physical examination.