Perinatal outcomes and maternal clinical characteristics in IUGR with absent or reversed end-diastolic flow velocity in the umbilical artery

Abstract

Purpose: The aim of this study was to evaluate the effect of absent or reversed end-diastolic umbilical artery Doppler flow on neonatal outcome independent of oligohydramnios, gestational age, and maternal factors.

Methods: From January 2004 to March 2010 we reviewed 76 cases at our hospital, which were diagnosed with intrauterine growth restriction (IUGR). Among those cases, the existence of absent or reversed end-diastolic velocity of umbilical artery (AEDV) was considered abnormal. We set the group that had no abnormal signs as the control group (57 cases), and compared it with the AEDV group (19 cases). Logistic regression was used to control for oligohydramnios and gestational age.

Results: The gestational age was lower in the AEDV group compared to that of the control group. Neonatal weight, platelet count were also lower in the AEDV group and serum SGOT level, the frequency of non-reassuring fetal heart beat pattern were higher in AEDV group compared to that of the control group independent of gestational age. Perinatal outcomes such as Apgar score at 1 min below 4, use of a ventilator, admission to the neonatal intensive care unit (NICU), respiratory disease, neurologic disease, neonatal sepsis, anemia, thrombocytopenia, and neonatal mortality were statistically less favorable in the AEDV group compared to those in the control group independent of gestational age and presence of oligohydramnios. There were more intrauterine fetal death histories and preeclampsia in the AEDV group compared the control group.

Conclusion: The waveform of umbilical artery Doppler velocity is an informative parameter of perinatal outcomes independent of gestational age or the presence of oligohydramnios in IUGR patients. It is especially important to check the waveform of umbilical artery Doppler velocity in IUGR patients with preeclampsia and IUGR patients with FDIU history.