Obstetric and neonatal outcome in fetuses with absent end-diastolic velocities of the umbilical artery: a case-controlled study.
Absence of end-diastolic velocities (AEDV) is the most severe waveform abnormality detected by Doppler ultrasound examination of the umbilical artery. It is associated with fetal hypoxemia and acidemia. If AEDV predisposed to more neonatal complications, then it might be an indication for earlier delivery. This was investigated in 21 preterm fetuses with AEDV who were matched for gestational age at delivery with 21 with end-diastolic velocities. All fetuses were delivered electively before 36 weeks' gestation of mothers who were hypertensive. The fetal heart rate (FHR) variability, birthweight, and umbilical arterial blood pH were significantly lower in the AEDV group. However, the neonatal outcomes were similar except for less severe hyaline membrane disease and lower initial platelet counts in the AEDV group. At present, fetuses with umbilical arterial AEDV need not be delivered earlier than indicated by the FHR pattern, nor should neonatal management be altered on the basis of antenatal AEDV.
Pattinson
R C
RC
Nuffield Department of Obstetrics and Gynecology, John Radcliffe Hospital, Oxford, United Kingdom.
Hope
P
P
Imhoff
R
R
Manning
N
N
Mannion
V
V
Redman
C W
CW
D000138:Acidosis / Q000097:blood; D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003971:Diastole; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D010927:Placental Insufficiency / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014655:Vascular Resistance