{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T18:59:54Z","timestamp":1777316394079,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\u2014There are conflicting data in the international literature on the risks of abnormal fetal growth in fetuses presenting an isolated single umbilical artery (SUA), and the pathophysiology of this complication is poorly understood. Objective\u2014To evaluate if changes in diameter of the remaining umbilical artery in fetuses presenting an isolated SUA are associated with different fetal growth patterns. Study design\u2014This was a two-center prospective longitudinal observational study including 164 fetuses diagnosed with a SUA at the 20\u201322-week detailed ultrasound examination and 200 control fetuses with a three-vessel cord. In all cases, the diameters of the cord vessels were measured in a transverse view of the central portion of the umbilical cord, and the number of cord vessels was confirmed at delivery. Logistic regression and nonparametric receiver operating characteristic (ROC) analysis were carried out to evaluate the association of the umbilical artery diameter in a single artery with small for-gestational age (SGA) and with fetal growth restriction (FGR). The impact of artery dimension was adjusted for maternal BMI, parity, ethnicity, side of the remaining umbilical artery and umbilical resistance index (RI) in the regression model. Results\u2014A significantly (p &lt; 0.001) larger mean diameter was found for the remaining artery in fetuses with SUA compared with controls (3.0 \u00b1 0.9 vs. 2.5 \u00b1 0.6 mm). After controlling for BMI and parity, we found no difference in umbilical resistance and side of the remaining umbilical artery between the SUA and control groups. A remaining umbilical artery diameter of &gt;3.1 mm was found to be associated with a lower risk of FGR, but this association failed to be statistical significant (OR = 0.60, 95% CI = 0.33\u20131.09, p value = 0.089). We also found that the mean vein-to-artery area ratio was significantly (p &lt; 0.001) increased in the SUA group as compared with the controls (2.4 \u00b1 1.8 vs. 1.8 \u00b1 0.9; mean difference = 0.6; Cohen\u2019s d = 0.46). Conclusion\u2014In most fetuses with isolate SUA, the remaining artery diameter at 20-22 weeks is significantly larger than in controls. When there are no changes in the diameter and, in particular, if it remains &lt;3.1 mm, the risk of abnormal fetal growth is higher, and measurements of the diameter of the remaining artery could be used to identify fetuses at risk of FGR later in pregnancy.<\/jats:p>","DOI":"10.3390\/diagnostics13030571","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T05:09:20Z","timestamp":1675400960000},"page":"571","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Changes in Artery Diameters and Fetal Growth in Cases of Isolated Single Umbilical Artery"],"prefix":"10.3390","volume":"13","author":[{"given":"Elena","family":"Contro","sequence":"first","affiliation":[{"name":"Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS Sant\u2019Orsola-Malpighi, University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-0164","authenticated-orcid":false,"given":"Laura","family":"Larcher","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS Sant\u2019Orsola-Malpighi, University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-4223","authenticated-orcid":false,"given":"Jacopo","family":"Lenzi","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Valeriani","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS Sant\u2019Orsola-Malpighi, University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-1810","authenticated-orcid":false,"given":"Antonio","family":"Farina","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS Sant\u2019Orsola-Malpighi, University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Jauniaux","sequence":"additional","affiliation":[{"name":"EGA Institute for Women\u2019s Health, Faculty of Population Health Sciences, University College London, Stanmore HA7 4LP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"ref_1","unstructured":"Standring, S. 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