Abstract
OBJECTIVE--To determine whether intrauterine growth retardation associated with normal umbilical artery blood flow is a benign condition. DESIGN--A prospective comparative study of growth retarded fetuses with normal and abnormal umbilical artery blood flow. SETTING--The fetal assessment clinic of a large maternity hospital in Ireland. PATIENTS--179 Women with singleton pregnancies in which the fetal abdominal circumference, measured by ultrasonography, was below the fifth centile for gestation. MAIN OUTCOME MEASURES--Perinatal deaths, fetal distress requiring caesarean section, preterm delivery, cerebral irritation. RESULTS--Of 124 fetuses with normal flow, all physically normal fetuses survived but one baby had cerebral irritation; there were six preterm deliveries and four caesarean sections for fetal distress. Among 55 women with abnormal flow there were two midtrimester abortions, three perinatal deaths, and one case of cerebral irritation in physically normal fetuses. CONCLUSIONS--Intrauterine growth retardation associated with normal umbilical blood flow is a different entity from that associated with abnormal flow, normal flow being largely benign and abnormal flow carrying a serious risk of adverse outcome.
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- Clinch J. Perinatal mortality 1986 & 1987. Ir J Med Sci. 1989 Jun;158(6):148–149. doi: 10.1007/BF02943056. [DOI] [PubMed] [Google Scholar]
- Dempster J., Mires G. J., Patel N., Taylor D. J. Umbilical artery velocity waveforms: poor association with small-for-gestational-age babies. Br J Obstet Gynaecol. 1989 Jun;96(6):692–696. doi: 10.1111/j.1471-0528.1989.tb03284.x. [DOI] [PubMed] [Google Scholar]
- Hadlock F. P., Deter R. L., Harrist R. B., Park S. K. Fetal abdominal circumference as a predictor of menstrual age. AJR Am J Roentgenol. 1982 Aug;139(2):367–370. doi: 10.2214/ajr.139.2.367. [DOI] [PubMed] [Google Scholar]
- Hayes A., Daly L., O'Brien N. G., MacDonald D. Anthropometric standards for Irish newborn. Ir Med J. 1983 Feb;76(2):60, 62, 64-6 passim. [PubMed] [Google Scholar]
- Khoury M. J., Erickson J. D., Cordero J. F., McCarthy B. J. Congenital malformations and intrauterine growth retardation: a population study. Pediatrics. 1988 Jul;82(1):83–90. [PubMed] [Google Scholar]
- Manning F. A., Morrison I., Lange I. R., Harman C. R., Chamberlain P. F. Fetal assessment based on fetal biophysical profile scoring: experience in 12,620 referred high-risk pregnancies. I. Perinatal mortality by frequency and etiology. Am J Obstet Gynecol. 1985 Feb 1;151(3):343–350. doi: 10.1016/0002-9378(85)90301-1. [DOI] [PubMed] [Google Scholar]
- Marsál K., Persson P. H. Ultrasonic measurement of fetal blood velocity wave form as a secondary diagnostic test in screening for intrauterine growth retardation. J Clin Ultrasound. 1988 May;16(4):239–244. doi: 10.1002/jcu.1870160405. [DOI] [PubMed] [Google Scholar]
- Morris J. A., Gardner M. J. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1313–1316. doi: 10.1136/bmj.296.6632.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nicolaides K. H., Bilardo C. M., Soothill P. W., Campbell S. Absence of end diastolic frequencies in umbilical artery: a sign of fetal hypoxia and acidosis. BMJ. 1988 Oct 22;297(6655):1026–1027. doi: 10.1136/bmj.297.6655.1026. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Redman C. W. Examination of the placental circulation by Doppler ultrasound. BMJ. 1989 Mar 11;298(6674):621–622. doi: 10.1136/bmj.298.6674.621. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soothill P. W., Nicolaides K. H., Bilardo C. M., Campbell S. Relation of fetal hypoxia in growth retardation to mean blood velocity in the fetal aorta. Lancet. 1986 Nov 15;2(8516):1118–1120. doi: 10.1016/s0140-6736(86)90529-5. [DOI] [PubMed] [Google Scholar]
- Stuart B., Drumm J., FitzGerald D. E., Duignan N. M. Fetal blood velocity waveforms in normal pregnancy. Br J Obstet Gynaecol. 1980 Sep;87(9):780–785. doi: 10.1111/j.1471-0528.1980.tb04613.x. [DOI] [PubMed] [Google Scholar]
- Trudinger B. J., Cook C. M. Umbilical and uterine artery flow velocity waveforms in pregnancy associated with major fetal abnormality. Br J Obstet Gynaecol. 1985 Jul;92(7):666–670. doi: 10.1111/j.1471-0528.1985.tb01445.x. [DOI] [PubMed] [Google Scholar]