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| 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.”
