Outcome of 88 pregnancies with absent or reversed end-diastolic blood flow (ARED flow) in the umbilical arteries.
OBJECTIVE
To investigate both perinatal and postneonatal morbidity and mortality in fetuses with absent or reversed end-diastolic flow (ARED flow) in the umbilical artery.


METHODS
A 5 year prospective follow-up of 88 fetuses with ARED flow.


RESULTS
Sixteen stillbirths, 16 neonatal deaths, six postneonatal deaths and one death at 2 years of age were noted. Out of the 42 fetuses born alive, 36 showed a normal neurological development whereas six were mentally handicapped. Adverse prognosis was more frequently found in the group with absent end-diastolic flow at first examination and then reversed flow until delivery, compared to the groups of always absent or always reversed end-diastolic flows.


CONCLUSIONS
Prompt delivery is recommended in these high-risk pregnancies in order to prevent long-term sequelae, obviously depending on the local limits of viability. Further studies appropriately designed for assessing long-term neurodevelopment of fetuses with ARED flow, although demanding, are mandatory.
Montenegro
N
N
Department of Obstetrics and Gynecology, University Hospital of S. João, Oporto, Portugal.
Santos
F
F
Tavares
E
E
Matias
A
A
Barros
H
H
Leite
L P
LP
D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D021041:Placental Circulation / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*