The significance of absent end-diastolic flow in the umbilical artery combined with reduced fetal cardiac output estimation in pregnancies at high risk for placental insufficiency

Abstract

In 138 pregnancies with suspected intra-uterine growth retardation, the umbilical artery flow velocity waveforms and fetal cardiac output estimations were correlated with the outcome of the pregnancy. Eighty-one cases had normal umbilical artery flow velocity waveform patterns and 57 cases had abnormal patterns, 19 of which had absence or reversal of end-diastolic velocity on Doppler examination. Eleven had reduced fetal cardiac output; these were all fetuses with absent end-diastolic velocity and all died. Cases with absent end-diastolic flow were more likely to have caesarean section for fetal distress, low Apgar scores, small for dates babies, neonatal intensive care admissions, a lower gestational age at delivery and a higher perinatal mortality rate in comparison with other groups. Absent or reversed end-diastolic velocity is indicative of severe fetal compromise, especially when associated with reduced fetal cardiac output. Show more