Umbilical artery Doppler flow velocimetry in intrauterine growth restriction and its relation to perinatal outcome.
OBJECTIVE
The purpose of this retrospective analysis was to compare pregnancy outcomes in growth-restricted fetuses retaining normal umbilical artery Doppler flow and the outcomes of pregnancies with end-diastolic velocity either diminished or severely reduced/absent.


METHODS
One hundred pregnant women with growth-restricted fetuses were followed with Doppler velocimetry of the umbilical artery between weeks 28 and 41 of pregnancy. Outcomes were compared for the normal Doppler group (16%), the less-severely abnormal group (77%), and the group with severely reduced or absent end-diastolic velocity waveforms (7%).


RESULTS
The diagnosis-to-delivery interval was significantly shorter, and the average birth weight and gestational age at delivery were significantly lower, for fetuses with abnormal Doppler velocimetry (showing diminished or severely reduced/absent end-diastolic velocity) than for those in the normal Doppler group. Fetuses with abnormal Doppler velocimetry also had a significantly higher incidence of oligohydramnios, low-birth weight (<10th percentile), and admission to the Neonatal Intensive Care Unit. There were no perinatal deaths among the normal Doppler patients.


CONCLUSIONS
Growth-restricted fetuses with normal umbilical artery velocimetry are at significantly lower risk than those with abnormal velocity waveforms, and immediate delivery of the fetus with diminished end-diastolic flow may be unnecessary. Knowing this relationship may be useful in the clinical management of such pregnancies. Doppler surveillance of growth-restricted fetuses supplemented with cardiotocography, preferably combined with biophysical profile testing, results in a prolonged gestational age and acceptable fetal outcome.
Seyam
Y S
YS
Department of Obstetrics & Gynecology, Women's Hospital, Doha, Qatar. yousrasiam@hotmail.com
Al-Mahmeid
M S
MS
Al-Tamimi
H K
HK
D000293:Adolescent; D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications* / Q000000981:diagnostic imaging; D005311:Fetal Hypoxia / Q000000981:diagnostic imaging / Q000209:etiology*; D006439:Hemodynamics; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012307:Risk Factors; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology*