Reversed end-diastolic flow in first-trimester umbilical artery: an ominous new sign for fetal outcome

Am J Obstet Gynecol. 2001 Jul;185(1):204-7. doi: 10.1067/mob.2001.114872.

Abstract

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.

Study design: 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.

MeSH terms

  • Chorionic Villi Sampling
  • Congenital Abnormalities / diagnosis
  • Cytogenetic Analysis
  • Diastole*
  • Female
  • Fetal Death
  • Fetal Diseases / diagnostic imaging*
  • Fetal Hypoxia / etiology
  • Fetofetal Transfusion / complications
  • Gestational Age
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / diagnosis
  • Humans
  • Neck / diagnostic imaging
  • Neck / embryology
  • Pregnancy
  • Pregnancy Outcome*
  • Trisomy
  • Ultrasonography
  • Umbilical Arteries / diagnostic imaging*
  • Umbilical Arteries / physiopathology
  • Vascular Diseases / complications
  • Vascular Diseases / diagnostic imaging*
  • Vascular Diseases / physiopathology