Absent end-diastolic velocity in umbilical artery: Risk of neonatal morbidity and brain damage

Valcamonico, Adriana; Danti, Luana; Frusca, T.; Soregaroli, Mirella; Zucca, S; Abrami, Francesco; Tiberti, Alessandra

doi:10.1016/s0002-9378(94)70285-3

Cited by 147 publications

(76 citation statements)

References 11 publications

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“…It is known that fetuses of high risk pregnancies with AREDFV have an increased risk of intrauterine or early neonatal death compared to fetuses with forward end diastolic flow velocity (FEDFV) in the cord umbilical artery or aorta. [1][2][3] They are more likely to be born preterm, 3 4 and small for gestational age (SGA). 5 6 Associations have been reported between AREDFV and fetal hypoxia and acidosis, 7 neonatal acidosis, [8][9][10][11] cerebral haemorrhage, 3 12-14 hypotension, 3 respiratory distress syndrome, 9 bronchopulmonary dysplasia, 13 necrotising enterocolitis, 1 13 14 and prolonged hospitalisation.…”

mentioning

confidence: 99%

Outcome at school age following antenatal detection of absent or reversed end diastolic flow velocity in the umbilical artery

Schreuder

McDonnell²,

Gaffney³

et al. 2002

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Aim: To determine whether fetal compromise, manifested by abnormalities of Doppler recordings of umbilical artery velocity waveforms in utero, is associated with neurodevelopmental or educational abnormalities at school age. Methods: A cohort of neonates born following high risk pregnancies had been previously identified for a study of the perinatal sequelae of absent (AEDFV) and reversed (REDFV) end diastolic flow velocities. Seventy six children were assessed at 5-12 years of age by a developmental paediatrician who was blinded to perinatal course and Doppler assessments. Forty children born following pregnancies with forward end diastolic flow velocities (FEDFV), were compared with 27 with AEDFV and nine with REDFV. Tests of cognitive, neurological, and sensory function were performed, and reports of behavioural and educational progress were obtained from parents and teachers. Results: There were no significant differences between FEDFV and AEDFV groups, but on tests of mental ability and neuromotor function the REDFV group had worse scores than either FEDFV or AEDFV. Comparing REDFV and FEDFV groups, the British Ability Scales general conceptual ability mean scores were 87.7 versus 101, and the Quick Neurological Screening Test mean scores were 32.8 versus 21.5. Conclusions: Absence of EDFV is well recognised as a marker of fetal compromise which is associated with acute perinatal sequelae. This study suggests it is not associated with adverse neurodevelopmental outcome. However, we found reversal of EDFV on antenatal assessment to be associated with a wide range of problems at school age, suggesting that REDFV represents intrauterine decompensation which may have adverse effects on the developing brain.

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mentioning

confidence: 99%

Outcome at school age following antenatal detection of absent or reversed end diastolic flow velocity in the umbilical artery

Schreuder

McDonnell²,

Gaffney³

et al. 2002

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…It has also been demonstrated that FGR 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 FGR fetuses with positive diastolic flow in the umbilical circulation [68].…”

Section: Umbilical Artery Dopplermentioning

confidence: 99%

Early onset fetal growth restriction

Nawathe

Lees

2017

Best Practice & Research Clinical Obstetrics & Gynaecol

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Fetal growth restriction (FGR) diagnosed before 32 weeks is identified by fetal smallness associated with Doppler abnormalities and is associated with significant perinatal morbidity and mortality and maternal complications. Recent studies have provided new insights into pathophysiology, management options and postnatal outcomes of FGR. In this paper we review the available evidence regarding diagnosis, management and prognosis of fetuses diagnosed with FGR before 32 weeks of gestation.

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“…In addition to increased fetal and neonatal mortality, this finding is also associated with increased risk of long-term abnormal neurodevelopment. 85 However, a multicenter randomized trial, 86 the growth restriction intervention trial (GRIT), found that early delivery prompted by umbilical artery reversed end-diastolic flow does not improve the mortality rate or the neurological outcome in preterm IUGR fetuses, supporting the concept that a safe interval of 24-48 hours exists to allow for corticoid administration for lung maturation.…”

Section: Umbilical Arterymentioning

confidence: 99%