Extent of Absent End Diastolic Flow in Umbilical Artery Doppler and Its Prediction of Adverse Perinatal Outcome-A...

The primary objective of this prospective study was to identify the predictive value of the extent of absent end diastolic flow (AEDF) (T_a/T_total ratio) for the adverse perinatal outcome (APO) in growth-restricted fetuses with AEDF.

In this prospective study, a novel parameter T_a/T_total ratio, was measured in fetal growth-restricted (FGR) Fetuses with AEDF in the umbilical artery (UA) Doppler between 26 and 34 weeks. All pregnancies were monitored throughout gestation and continued to be followed up till neonatal period for any APO. Ta represents the duration of AEDF, and T_tot denotes the total duration of the cardiac cycle (T_total) in the UA Doppler, which was recorded at the last examination before delivery.

Seventy-eight FGR fetuses with AEDF were included in the study. Mean gestational age (GA) at delivery, T_a/T_total ratio, and mean birth weight were 30.40 ± 4.02 weeks, 0.30 ± 0.10, and 992.82 ± 373.82 grams, respectively. Stillbirths 19 (25%) and neonatal deaths 6 (8%) were reported. T_a/T_total ratio cut-off of 0.42 predicted APO with 96% specificity, 82% positive predictive value (PPV), and 76% negative predictive value (NPV), though sensitivity was 36% (area under ROC curve, 0.70 [0.57-0.82], p < .001).

In fetuses with AEDF with normal DV Doppler, the extent of absent flow for ≥42% of the total cardiac cycle length might predict the risk of APO with high specificity and PPV.