Significance of an absent or reversed end diastolic flow in Doppler umbilical artery waveforms

The outcome of nine fetuses in whom Doppler umbilical arterial velocity-time waveforms showed absence or reversal of flow in end diastole was presented. Eight of the nine resulted in either intrauterine or neonatal death. Progressive deleterious changes in the waveforms were evident in three fetuses who had serial evaluation. The remaining infant survived when delivery was expected 2 days later. Our data have indicated that the demonstration of an absent or reversed flow in end diastole in the umbilical arteries carries with it a very specific indication of serious fetal compromise and the need for immediate delivery, although the prognosis of a normal neonatal survival remains guarded.