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Absent or reverse end-diastolic flow in the umbilical artery: intellectual development at school age

Adriana Valcamonico1, Patrizia Accorsi, Silvia Battaglia

  • 1Department of Obstetrics and Gynecology, University of Brescia, Italy. lufa1963@numerica.it

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|April 22, 2004
PubMed

Insights

Absent or reverse end-diastolic (ARED) flow in umbilical arteries of growth-restricted fetuses predicts neurological issues but not intellectual deficits later in life. This Doppler velocimetry finding aids in identifying at-risk children.

Area of Science:

  • Fetal Medicine
  • Neurodevelopmental Pediatrics
  • Doppler Ultrasound

Background:

  • Intrauterine growth retardation (IUGR) poses risks for long-term neurodevelopmental outcomes.
  • Umbilical artery Doppler velocimetry is a key tool in assessing fetal well-being.
  • Absent or reverse end-diastolic (ARED) flow is a concerning Doppler finding in IUGR.

Purpose of the Study:

  • To determine if ARED flow in umbilical arteries of growth-retarded fetuses predicts future neurological and intellectual impairment.
  • To evaluate the long-term neurodevelopmental outcomes in children with and without ARED flow during fetal growth retardation.

Main Methods:

  • A cohort of 14 children with IUGR and ARED flow and 11 controls were assessed by pediatric neuropsychiatrists.
  • Neurological and intellectual development were evaluated at a median age of 8.7 years.
  • Intelligence was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R).

Main Results:

  • Children with fetal ARED flow showed a higher incidence of major (21% vs 9%) and mild (35% vs 27%) neurological sequelae.
  • No significant differences in mean intelligence quotient (IQ) were observed between the groups at school age.
  • Umbilical artery Doppler velocimetry indicated a higher risk for neurological sequelae in the ARED group.

Conclusions:

  • Umbilical artery Doppler velocimetry, specifically ARED flow, is a reliable predictor of neurological sequelae in children with IUGR.
  • ARED flow is not a reliable predictor of intellectual performance at school age.
  • Doppler velocimetry aids in identifying fetuses at risk for adverse neurological outcomes.
Abstract

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