Background: A single umbilical artery (SUA) in a fetus may be associated with hydronephrosis.
Cases: We describe 2 cases of SUA, one of which had severe hydronephrosis with ascites and was stillborn. The other case was born alive with a unilateral hydroureter and is being managed with close monitoring.
Conclusion: Detection of SUA on antenatal ultrasound should prompt a careful search for urinary tract abnormalities, as associated severe hydronephrosis may lead to a poor outcome.
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