Risk of fetal deaths in absent or reversed end-diastolic velocities in the umbilical artery quantified

Radiology Key

Growth restricted fetuses with a absent or reversed end-diastolic velocities in the umbilical artery or ductus venosus before 34 weeks of gestation are at considerable increases risk of intrauterine demise (IUD) reports the result of a systematic review and meta-analysis published electronically ahead of print in American Journal of Obstetrics and Gynecology.

A total of 31 observational and randomized controlled trials met the inclusion criteria of early-onset growth-restricted fetuses (diagnosed before 34 weeks of gestation), absent or reversed end-diastolic velocities in the umbilical artery or ductus venosus and the pregnancy outcomes in these pregnancies.

It was seen that fetus with absent umbilical artery end-diastolic velocity were nearly 3.5 times more at risk of fetal death as compared to fetuses with normal velocities (OR 3.59; 95% CI 2.3–5.6).

The risk was nearly 7 times in fetuses with umbilical artery reversed end-diastolic velocity (OR 7.27; 95% CI 4.6–11.4) and 11 times for ductus venosus absent or reversed end-diastolic velocity (OR 11.6; 95% CI 6.3–19.7).

Abnormal umbilical artery flow with absent or reversed end-diastolic velocity is a strong indication of placental insufficiency and these pregnancies should be subjected to close follow-up and early delivery.

The authors concluded that, “Early-onset growth-restricted fetuses with either umbilical artery or ductus venosus absent or reserved end-diastolic velocities are at a substantially increased risk for fetal death.”

Abstract