Do well infants born with an isolated single umbilical artery need investigation?

You are the paediatric house officer performing discharge examinations on the postnatal ward. You are informed of this term neonate whose umbilical cord was noted to have a single umbilical artery (SUA) at delivery. He is otherwise well. You cannot detect any abnormalities on physical examination. Historically, SUA has been said to be associated with congenital malformations of different organ systems. You wish to appraise the evidence whether or not this infant needs investigations to detect associated malformations. In a term neonate with no other obvious congenital malformations [patient] does the presence of a single umbilical artery [risk factor] necessitate further investigation [intervention] to exclude associated malformations [outcome]? Primary source: Medline via Pubmed using keyword “umbilical artery”. A total of 477 individual articles were found. This was limited to 152 articles by selecting those in English language and human studies relating to neonates (birth–1 month). The search was verified …