Absent end-diastolic velocity in umbilical artery: risk of neonatal morbidity and brain damage.
OBJECTIVE
We conducted a cohort study in growth-retarded fetuses to establish if absent or reverse end-diastolic flow in the umbilical artery was associated with increased perinatal mortality and morbidity and neurologic damage at long-term follow-up.


METHODS
Thirty-one fetuses with intrauterine growth retardation and absent or reverse end-diastolic flow in the umbilical artery (study group) and 40 growth-retarded fetuses with detectable diastolic flow in the umbilical artery, divided into two control groups, were followed up with serial nonstress tests, Doppler flow studies, and biophysical profiles. Twenty newborns from the study group survived the perinatal period and were observed for a mean of 18 months (range 12 to 24 months). Their neurologic outcomes were compared with those of 26 neonates from the two control groups.


RESULTS
Study group fetuses had a higher incidence of abnormal karyotype (9.7% vs 0%) and corrected perinatal mortality (26% vs 6% and 4%) and a greater risk of permanent neurologic sequelae (35% vs 0% and 12%) compared with the fetuses from the two control groups.


CONCLUSIONS
Growth-retarded fetuses with absent or reverse end-diastolic flow in the umbilical artery not only have an increased fetal and neonatal mortality but also a higher incidence of long-term permanent neurologic damage when compared with growth-retarded fetuses with diastolic flow in the umbilical circulation.
Valcamonico
A
A
Department of Obstetrics and Gynecology, University of Brescia, Italy.
Danti
L
L
Frusca
T
T
Soregaroli
M
M
Zucca
S
S
Abrami
F
F
Tiberti
A
A
D001783:Blood Flow Velocity; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D003971:Diastole; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012039:Regional Blood Flow; D012307:Risk Factors; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology*