Our Single Umbilical Artery (SUA) Pregnancy Experience

single umbilical artery

Image of single umbilical artery from myhealth.alberta.ca

There was really no point in my pregnancy that I was not afraid I was going to lose the baby. In part, that fear stemmed from the emotional rollercoaster that pregnancy after loss can be under the best circumstances. And, in part, it arose from finding out that the baby and I had a single umbilical artery.

We found out about the SUA at our 20 week anomaly scan, and the doctors were moderately reassuring. I am a researcher by training, however, and when I went in search of more information on my own, what I found was just frightening. And I couldn’t find any stories from families—just a bunch of medical journal articles that kept me up at night with visions of stillbirth. So, I wanted to share our story to put something a little more personal out there, in case you find yourself in this situation. DISCLAIMER: please do not take this as medical advice. I’m not that kind of doctor. This is just our family’s story.

What is a single umbilical artery?

I had never heard of it before, but a single umbilical artery affects an estimated 1 in 100 pregnancies. Not that rare, really. Basically, a typical umbilical cord is made up of one big vessel and two arteries. One of the midwives told me that it looks like a smiley face. The vessel is what brings the blood, oxygen, and nutrients to the baby. The arteries are what carry waste away from the baby. In theory, having just one of those arteries does not have to affect the baby whatsoever. At least 75% of these babies come out just fine and you’d never know that there was a SUA unless it was found on the ultrasound or until cutting the cord. A lot of doctors don’t even check for it.

When paired with other anomalies, however, a SUA can be a soft marker for chromosomal abnormalities. On our 20-week scan, they also saw a “bright spot” on our daughter’s heart. I knew something was up, because the sonographer, who isn’t allowed to really say anything, asked twice if I’d had a Quad Screen done. Again, on its own, that bright spot means nothing, but with the two put together… The doctor (a specialist, not my usual provider) told me that with those two markers and my age (ahem, I am only 33, thank you very much), he’d put the chance of Down Syndrome at about 1 in 300 and he recommended that we do genetic testing.

By the way, because of COVID-19 restrictions, my husband was not in the room for any of that. We video called him in for the gender reveal, but after we hung up is when I got all the complicated news. I had some blood drawn for the testing and then went to the lobby to meet him and fill him in.

The five days between when we had our appointment and when we got the results of the genetic testing back were agonizing. I made the mistake of Googling some of the chromosomal abnormalities that the test checked for and several of them were fatal. We breathed a huge sigh of relief when the testing came back negative. Although there was still a chance of complications, particularly in the baby’s heart or kidneys, we were at least 99% sure that we were not looking at something major.

Still, however, I had a hard time not worrying about potential complications. Not everything can be diagnosed from an ultrasound. And in the literature on SUA, increased risk of stillbirth came up over and over. I tried not to worry too much, committing myself instead to praying that our girl would come to us healthy.

Are we having Intrauterine Growth Restriction (IUGR)?

Our next in-person appointment was a growth ultrasound at 28 weeks. This was the last time Julio was allowed to come to a prenatal appointment, and even then they only let him come because I just showed up with him, not realizing that the policy at my OB’s office had changed. Because the SUA can lead to Intra-Uterine Growth Restriction and related issues, our baby was getting a little extra monitoring, thus the ultrasound. Although her legs were pretty long and that put her in the 35th percentile overall, her head and belly were measuring just under the 5th percentile. Tiny. IUGR is typically diagnosed when the measurements fall under the 5th percentile. The midwife who met with us to go over the results decided to refer us back to the specialists for another growth ultrasound in two weeks, explaining that their equipment was better and she wanted to be sure that this slowdown in growth was not due to a difference in equipment or technique between the two offices.

It was really hard not to feel like I was failing. It had taken us so long to make this baby and now she wasn’t growing. The midwife told me, more than once, that there was nothing that I was doing or not doing that was causing the SUA or the dropoff in growth. She reminded me that the umbilical cord forms based on DNA that I can’t control. I asked if I needed to eat more—I was already focusing so much on eating nutrient-dense food every couple of hours. She said that giving the placenta good nutrition couldn’t hurt, but how the nutrients were delivered to the baby also was not something I could control. It just was what it was. I personally, do not connect with the phrase “it is what it is.” I ate more anyway. Grow, baby, grow.

At 30 weeks, we headed back to the specialists for another growth ultrasound. The sonographer really took her time to get good measurements, confirming with the doctor that she had done one of them correctly (the baby was not positioned super conveniently), which I really appreciated. The doc talked to me about the results of our genetic testing and looked at the ultrasound. The baby was still small, but her head and belly measurements were up over 10% and her interval growth looked good, so he referred me back downstairs to my primary practice, saying that they should refer me back upstairs if anything changed, but for now he thought we were okay.

“Oh, he’s the guy up there,” the midwife told me when she looked at the report from our ultrasound. That gave me a lot of comfort. So, the plan was to just keep monitoring the baby closely.

Weekly Fetal Non-stress Tests (NST)

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A fetal non-stress test

Starting at 32 weeks, I had weekly visits for a fetal non-stress test, which basically is a non-invasive way to monitor the health of the baby and that she is getting enough oxygen. I wore two sensors, one that picked up the baby’s heart rate and another that picked up movement by or in the uterus. The test result is either reactive or non-reactive. A good, reactive result shows that when a baby moves, their heart rate picks up and then comes back to their baseline. Our daughter passed these every time and I actually really enjoyed listening to her heartbeat for 20-40 minutes every week.

At 36 weeks, we had another growth ultrasound and, although the dopplers on the umbilical cord looked good and our girl was growing, her growth had dropped off and her belly was back down to the 4th percentile. Typically, when growth slows, the belly is the first place to taper off. Her head was just over the 5th percentile. One of the doctors at the practice we go to advised the midwife that we should consider inducing at 39 weeks to “quit while we’re ahead,” rather than risk the placenta not doing its job. Another ultrasound was scheduled for 38 weeks, with the plan to discuss the week 39 induction further then.

Honestly, talk of an induction took birth from something that I had no fear or anxiety about to something that I was quite anxious about. I felt strongly drawn toward unmedicated, low-intervention birth and I knew that, while inductions can be no big deal, they can also lead to long, very painful delivery and increase the odds of having a cesarean birth. At 37 weeks, I discussed these concerns with the midwife and she and I went over some things I could do to encourage spontaneous labor at home, in hopes that I could get baby to come on her own before an induction. She was already sitting pretty low, so I felt hopeful and reassured.

At 38 weeks, the growth ultrasound showed that, while baby girl was holding onto the 24th percentile, with a small head and belly, but legs in the 88th percentile, her interval growth was still coming along. She was not growth restricted, but she was probably going to be small. The NST showed a very active baby. So, the decision was made not to schedule the induction and keep trying for spontaneous labor. I was told, though, that for me “the margin for anything weird is low” and I should call the midwives if anything changed at all. The baby had also turned face down and was riding even lower. Yay.

What Happened?

The doctors wanted the baby born by 40 weeks, but my midwife thought that she was doing well and we could try to get her to 40 weeks. The compromise was that we scheduled an induction on my due date. I was told that while births for kids with SUAs can go smoothly, they can also get a little weird. I tried everything to get labor going. I walked so much that I hurt my hip. But, baby girl was staying put. Maybe it’s because I watched the news every night during my pregnancy and she had heard too much about 2020 to want to come out. I don’t know, but I went in for a COVID-19 test two days before our due date, and we reported for the induction on our due date with this mama feeling some combination of resigned to it and at peace with it.

We took the induction the slowest, gentlest possible route so that if the baby was not tolerating any of the methods, we could stop or slow down. A day and a half later, our daughter was born! Her APGAR scores were high, she nursed right away, and there are no signs of any complications related to that pesky umbilical artery. And that little head that had everyone worried? At birth, her head was at exactly the 50th percentile and she was well over six pounds. She’s pretty cute, too.

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I am so grateful that our girl moved a lot throughout the pregnancy, so I had continuous reminders that she was okay. I am also so thankful for the support of our midwife and the doctors who monitored our baby, but also took a holistic view of her health and mine—even after the induction, I still got the unmedicated, intervention-free delivery that I wanted, once labor started. I am grateful for the prayers of friends and family and that we have good insurance and that I had sick time for all those appointments. Most of all, I am grateful that we have a healthy daughter sleeping on me as I finish writing this.

After delivery, my midwife showed the umbilical cord to the nurses and sent the placenta off to be analyzed, as is standard practice when there is an abnormality with it or the cord. The baby nurse present for our delivery told Julio that his 18 month-old daughter had a SUA and was doing great. “Watch out for those single umbilical artery girls; they’re feisty,” he said.

If you have a SUA, I know that what is out there on the internet can be really scary, but in most cases your baby will be okay. Listen to your doctors, but also take some deep breaths and stay off of Google.

49 thoughts on “Our Single Umbilical Artery (SUA) Pregnancy Experience

  1. Thank you for your article,

    We just heard today that our baby has a SVA (16 weeks).
    So nice to read you. the journey might be long but will be ok.

      • Coming back with news.
        Our baby is born 3 weeks ago.
        Super healthy. 3,2kg on week 37.

        We did all the tests during the pregnancy (NIPT, amniocentesis, heart ultrasound) which all came back clean.

        It was a crazy/scary journey. But so worth it.

    • I’m back with some news! Our baby is born 6 days ago. 37 weeks of pregnancy. Fully healthy baby.
      At 16 weeks of pregnancy we discovered a single umbilical artery, an egocentric focus (calcium point in the heart). We did an NIPT test, amniocentese and an ultrasound of the heart. All came back goods.

      We finished the pregnancy with ultrasound every 3 weeks to check that the baby was growing well. And he was! He’s born week 37 (spontaneous labour) at 3,2kg.

      Wishing everyone lot of strength and optimism in this crazy journey.
      Ans thank you – this article helped us a lot few months ago.

      Hanna

  2. Thank you for sharing your experience!!

    I just found out today that the boy I’m expecting is growing with a SUA at 25 weeks. No other markers have been found, and we had already been screened for chromosomal and genetic issues and ruled out clean. Not only that, but the little dude is at the 94th percentile, almost two weeks ahead in size. Pretty clearly there’s no concerns in growth.

    I still did the mistake of going Googling. My saving grace is that I’m bilingual; the medical information available in my mother’s tongue is a lot less dramatic and a lot more factual, than the Google results available in English. Especially American articles are just ridiculously misleading; I can almost see the healthcare providers fishing for parental worry and thus, money coming from extra screenings, many of those invasive. It’s infuriating to read, when you see how differently the same subject is presented.

    In medical articles available in Finnish from the past couple years, they make it abundantly clear that modern medical research of SUA overrules the old understanding of SUA itself causing any problems, and rarely even being linked to them. It’s just that traditionally, it was often diagnosed only when/after other issues were found, too. To this date, in most western countries, they don’t even look for SUA in abnormality scans. Finnish researchers stress that reading the old data saying SUA=problems, is like saying that broken wings cause fallen angels, because fallen angels were often found with broken wings. I haven’t found a single clear, academic article in English, that would approach SUA with modern meta data analysis and medical research results that are freely available via Finnish databases.

    UK tries though! Their healthcare considers SUA a normal variation, instead of malformation. What a difference in terminology, right?

    That said, my poor American, English-only-speaking husband still needs information and experiences in English, and I’ll be sure to share your post with him.

    Best to you, your husband and the feisty little girl!

    • Wow! Thanks so much for your perspective. The US does not do as well as our peers in fetal or maternal outcomes, so I’m not surprised that there’s a big difference here. I’m glad to hear that your baby is doing so well!

  3. I just want to thank you for sharing your experience. I was just diagnosed today with SUA at 22 weeks. My doctor told me there shouldn’t be any worries (our genetic blood tests had already come back with no problems) so we are just going to do ultrasounds each month to keep an eye on baby’s growth. But of course I came home and got on google (I told myself I wouldn’t but…) and until reading your article, I was scared out of my mind. Thank you, for your reassuring words! I will stay off of google now and focus on caring for this little one, praying, and expecting the best!!

    • I’m so glad I could offer some reassurance and I hope you and your baby stay healthy and happy! Later in my pregnancy, I got worried that my baby was hiccuping too much and there was a problem and What to Expect scared me until my midwife told me to stay off of the internet. There’s just so much to make a mama nervous!

  4. I was diagnosed today with SUA at 21 weeks with my baby boy, and it sacred me. It does not help that my husband and I lost our daughter this past april, she was in fact diagnosed with a chromosomal abnormality and we lost her at 26 weeks. We had done the genetic testing and had passed everything except for the nuchal translucency test. This time with our baby boy we passed that, and are less then 1% in the genetic testing to have anything. Our baby girl was a less then 1% abnormality that neither I nor my husband carried. my doctor is very confident that it is not genetically related but I am nervous still. I am scheduled for an echo of his heart in 4 weeks. They found a spot on it, did anything ever come from the spot they found on your baby girls ultrasound?

    • Hi. First of all, I am so very sorry for your loss and I hope that your baby boy continues to grow and thrive.
      For our daughter, nothing came of the spot on her heart. The pediatrician did hear a murmur in her heart at her first and second month checkups, which is not uncommon in babies that young, but because of a history of heart issues in my family, we took her to the children’s hospital for an echo and the doctor said he is almost positive that it is an innocent murmur that she will outgrow (he can’t be 100% positive because with very young babies everything is so small that something could be missed). That was very reassuring and hopefully, your echo is similarly reassuring.

  5. I’m back with an update – I commented back in December under the name Anna, when I found out my baby was growing on a SUA.

    He was born 2/27/21 at week 36+6 due to my preeclampsia. A completely healthy, happy baby!

  6. Oh my god I’m reading this and my eyes are full of tears you hot me I’m staying up late reading on google it’s scary
    I’m very thankful for this article and really i appreciate that you shared your experience with us
    I just found out about the SUA ! I’m scared don’t know what to believe!!
    I hope everything goes well for me just like you and our baby girl will come out to this world healthy
    Thank you one more time i can turn off the phone and sleep now

  7. Stumbled on your article hours after my 20 week ultrasound and finding out about SUA. I’m so glad i found it. I can totally relate to everything you spoke about, down to covid restrictions 🙄😂 and I’m so relieved about your happy ending. It sounds like such a long, and up and down journey, that I’m not sure ready I’m ready for, but your article gave me some peace of mind. Thank you so much for writing this piece ❤ and judging from the comments, you also enlightened other young ladies.

  8. Thank you so so much for sharing your story. I’m 16 weeks and I have SUA (did a preliminary anatomy scan and no other abnormalities for the moment) and you are so right, the internet and scientific articles are terrifying to say the least. I really appreciate you taking the time to put your story out into the world!

  9. Another thank you! Just got diagnosed with SUA at the 17 week ultrasound. My last birth had no issues, so this completely scarred me (also alone in the doctors office). Glad I found your story because the Google was not reassuring. The baby is measuring 75%.

  10. Coming back to help put other mamas at ease. I commented back in December when I was diagnosed with SUA. Five days ago I gave birth to a healthy baby boy! He joins 5 brothers and a sister 🙂 We had routine ultrasounds the last few months to monitor growth, but never even experienced anything concerning. Be at peace mamas. Every doctor I spoke with told me that they rarely have seen complications with SUA.

  11. Thank you for this ❤️ Currently going through this exact situation. I also have a two vessel cord and this morning at my 29 week ultrasound they found her belly to be measuring at the 5th percentile and told me that delivering at 37 weeks is most likely what we’re looking at. Grateful to hear your story and encouragement as I lay in bed on google, thank you for sharing!

  12. Thank you so much for ur personal experiences. Bcoz currently am facing same sua problem.Really ur Stories gives good booster. Thank you so much

  13. I just want to say thank you for sharing your experience. I just found out that my baby boy has an SUA and a bright spot of his heart as well. I’m so scared but hopeful that our baby will have a happy ending too.

  14. Thank you for this. I was just diagnosed two days ago with SUA. I have already had genetic testing because of other concerns and it all came out good, and when my dr told me my umbilical cord only had two vessels, he honestly kinda brushed it off like no big deal. I had never heard about it and wasn’t worried because my dr didn’t seem worried, but of course I got curious and looked it up and now my anxiety is through the roof. I am so glad everything worked out for you and baby and I pray my baby boy is healthy and has no complications as well. Thank you for your story.

  15. Thank you so much for taking time to share your experience in a way everyone understands and also in a very reassuring way.. this is something I really wanted after going through hundreds of scary articles on Google.. thank you and god bless you and everyone who commented down here about their experience.. everything looks so positive on this space and gives me a lot more strength now while I’m only at my 16th week, long way to go..

    • I hope everything goes smoothly for you! I’m so thankful for all the mamas who shared there stories too! ❤️

  16. Thank you so much for this article! It is so hard to find things online with nothing but horror stories. I am 28, second pregnancy and this time around I am being told our baby may be at risk for chromosome 47, XXY (not doing a amnio- gut is saying no) and was just told yesterday (19 weeks) by the maternal fetal specialist that I have single umbilical artery. I am a wind storm of emotions. Your story is uplifting and sends me hope !!

  17. Hi I am 35. I had no complications in my first pregnancy. I am now pregnant with my second(baby boy) and was diagnosed with SUA at 20 weeks ultra sound and they found his right kidney has a slight extra fluid and femur measuring 33%. We had genetic testing done which was negative but we skipped amniocentesis because the risk of complications we would have with the test. I am currently 27 weeks and was wondering if i made a mistake declining the amniocentesis. His movements are not the same as my first pregnancy, he keeps moving a lot and also I noticed he kicks more than once in a row sometimes(5-10 kicks in a row) since last 4 weeks. I am concerned if he has muscle spams/seizure, I called my doctors office they said it may be baby having hiccups but it doesn’t feel like hiccups because I they have to be spaced equally. I tried searching on the internet and all the explanations are scary. Wondering if anyone else had a similar experience.

    • I’m just seeing this comment. I hope that everything is going okay for you. ❤️ We skipped the amnio as well. My daughter had hiccups constantly and it really freaked me out. The nurse told me to stay off the internet! It is so hard when we’re nervous.

  18. Thanks so much for your detailed account of your experience. I just got diagnosed with SUA and feeling all the feels. I’m so happy for you and that you had a healthy baby girl ❤

  19. Hi guys, I’m back with an update.. a good and healthy one! I gave birth a month ago and everything was good with my baby girl! So i came back to hopefully bring some relief to other expectant moms with sua pregnancies. Towards the end of my pregnancy (38 weeks) , my baby slowed down with the weight gain but even then she was still at a good gestation age to be born.. and when she was born, which was a few days before my due date (thank God), she was born at 7lbs and healthy. Best of luck to everyone and id love to read your guys’ updates because they kept my hope when i was pregnant

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