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. 1997 Jan;76(1):F35–F38. doi: 10.1136/fn.76.1.f35

Effect of absent end diastolic flow velocity in the fetal umbilical artery on subsequent outcome

P Adiotomre, F Johnstone, I Laing
PMCID: PMC1720607  PMID: 9059184

Abstract

Sixty babies, delivered over a six and a half year period, who had absent end diastolic frequency (AEDF) in the umbilical artery, were studied. Individually matched control pregnancies for gestational age, birthweight, maternal clinical condition and date of delivery, in whom umbilical artery recordings showed end diastolic frequency, were also studied.
  Matching was achieved in 36 cases. Neonates from case pregnancies showed no increase in necrotising enterocolitis, intraventricular haemorrhage, pneumo-thorax, neonatal death or bronchopulmonary dysplasia. However, they were significantly less likely to require ventilation for respiratory distress syndrome (P=0.02).
  Although AEDF indicates a fetus under vascular stress, this finding alone will include a spectrum of response in the baby, from the well compensated to the irreversibly damaged. Delivery at different points in the deteriorating fetal environment may explain discrepant study results. This intrauterine stress, by increasing fetal corticosteroid and thyroid hormones, may account for enhanced lung maturity. Predictions of neonatal course need to be based on more comprehensive awareness of fetal status.

 Keywords: high risk pregnancies; end diastolic flow velocity; ventilation; respiratory distress syndrome.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cosmi E. V. Prenatal prevention of respiratory distress syndrome: new pharmacologic approaches. Early Hum Dev. 1992 Jun-Jul;29(1-3):283–286. doi: 10.1016/0378-3782(92)90165-d. [DOI] [PubMed] [Google Scholar]
  2. FitzGerald D. E., Drumm J. E. Non-invasive measurement of human fetal circulation using ultrasound: a new method. Br Med J. 1977 Dec 3;2(6100):1450–1451. doi: 10.1136/bmj.2.6100.1450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Hackett G. A., Campbell S., Gamsu H., Cohen-Overbeek T., Pearce J. M. Doppler studies in the growth retarded fetus and prediction of neonatal necrotising enterocolitis, haemorrhage, and neonatal morbidity. Br Med J (Clin Res Ed) 1987 Jan 3;294(6563):13–16. doi: 10.1136/bmj.294.6563.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Haddad N. G., Johnstone F. D., Hoskins P. R., Chambers S. E., Muir B. B., McDicken W. N. Umbilical artery Doppler waveform in pregnancies with uncomplicated intra-uterine growth retardation. Gynecol Obstet Invest. 1988;26(3):206–210. doi: 10.1159/000293695. [DOI] [PubMed] [Google Scholar]
  5. Johnstone F. D., Haddad N. G., Hoskins P., McDicken W., Chambers S., Muir B. Umbilical artery Doppler flow velocity waveform: the outcome of pregnancies with absent end diastolic flow. Eur J Obstet Gynecol Reprod Biol. 1988 Jul;28(3):171–178. doi: 10.1016/0028-2243(88)90027-5. [DOI] [PubMed] [Google Scholar]
  6. Johnstone F. D., Steel J. M., Haddad N. G., Hoskins P. R., Greer I. A., Chambers S. Doppler umbilical artery flow velocity waveforms in diabetic pregnancy. Br J Obstet Gynaecol. 1992 Feb;99(2):135–140. doi: 10.1111/j.1471-0528.1992.tb14472.x. [DOI] [PubMed] [Google Scholar]
  7. Knight D. B., Liggins G. C., Wealthall S. R. A randomized, controlled trial of antepartum thyrotropin-releasing hormone and betamethasone in the prevention of respiratory disease in preterm infants. Am J Obstet Gynecol. 1994 Jul;171(1):11–16. doi: 10.1016/s0002-9378(94)70070-2. [DOI] [PubMed] [Google Scholar]
  8. Kosloske A. M. Pathogenesis and prevention of necrotizing enterocolitis: a hypothesis based on personal observation and a review of the literature. Pediatrics. 1984 Dec;74(6):1086–1092. [PubMed] [Google Scholar]
  9. Malcolm G., Ellwood D., Devonald K., Beilby R., Henderson-Smart D. Absent or reversed end diastolic flow velocity in the umbilical artery and necrotising enterocolitis. Arch Dis Child. 1991 Jul;66(7 Spec No):805–807. doi: 10.1136/adc.66.7_spec_no.805. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. McDonnell M., Serra-Serra V., Gaffney G., Redman C. W., Hope P. L. Neonatal outcome after pregnancy complicated by abnormal velocity waveforms in the umbilical artery. Arch Dis Child Fetal Neonatal Ed. 1994 Mar;70(2):F84–F89. doi: 10.1136/fn.70.2.f84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. McDonnell M., Serra-Serra V., Gaffney G., Redman C. W., Hope P. L. Neonatal outcome after pregnancy complicated by abnormal velocity waveforms in the umbilical artery. Arch Dis Child Fetal Neonatal Ed. 1994 Mar;70(2):F84–F89. doi: 10.1136/fn.70.2.f84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Skidmore R., Woodcock J. P., Wells P. N. Physiological interpretation of Doppler-shift waveforms--III. Clinical results. Ultrasound Med Biol. 1980;6(3):227–231. doi: 10.1016/0301-5629(80)90017-4. [DOI] [PubMed] [Google Scholar]
  13. Thorpe-Beeston J. G., Nicolaides K. H., McGregor A. M. Fetal thyroid function. Thyroid. 1992 Fall;2(3):207–217. doi: 10.1089/thy.1992.2.207. [DOI] [PubMed] [Google Scholar]
  14. Trudinger B. J., Giles W. B., Cook C. M., Bombardieri J., Collins L. Fetal umbilical artery flow velocity waveforms and placental resistance: clinical significance. Br J Obstet Gynaecol. 1985 Jan;92(1):23–30. doi: 10.1111/j.1471-0528.1985.tb01044.x. [DOI] [PubMed] [Google Scholar]
  15. de Zegher F., Spitz B., Devlieger H. Prenatal treatment with thyrotrophin releasing hormone to prevent neonatal respiratory distress. Arch Dis Child. 1992 Apr;67(4 Spec No):450–454. doi: 10.1136/adc.67.4_spec_no.450. [DOI] [PMC free article] [PubMed] [Google Scholar]

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