Reversed end-diastolic flow in first-trimester umbilical artery: an ominous new sign for fetal outcome.
OBJECTIVE
The purpose of this study was to assess the fetal outcome of first-trimester pregnancies with reversed end-diastolic flow in the umbilical artery.


METHODS
Doppler studies in the umbilical artery were carried out in 2970 consecutive pregnancies scanned at 10 to 14 weeks.


RESULTS
We observed 11 (0.4%) cases of reversed end-diastolic flow. Of these, an autosomal trisomy was shown in 7 and a congenital heart defect in 2 additional fetuses. Fetal demise was observed in 5 pregnancies, neonatal death was observed in 1, and termination of pregnancy was carried out in 4. Only 1 fetus survived.


CONCLUSIONS
Reversed end-diastolic flow in first-trimester umbilical artery signals an ominous prognosis even with normal karyotype.
Borrell
A
A
Prenatal Diagnosis Unit, Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona Medical School, Villaroel 170, Barcelona 08036, Catalonia, Spain.
Martinez
J M
JM
Farre
M T
MT
Azulay
M
M
Cararach
V
V
Fortuny
A
A
D015193:Chorionic Villi Sampling; D000013:Congenital Abnormalities / Q000175:diagnosis; D020732:Cytogenetic Analysis; D003971:Diastole; D005260:Female; D005313:Fetal Death; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005311:Fetal Hypoxia / Q000209:etiology; D005330:Fetofetal Transfusion / Q000150:complications; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis; D006801:Humans; D009333:Neck / Q000000981:diagnostic imaging / Q000196:embryology; D011247:Pregnancy; D011256:Pregnancy Outcome; D014314:Trisomy; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014652:Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology