EFFECT OF ABSENT END-DIASTOLIC FLOW VELOCITY IN THE FETAL UMBILICAL ARTERY ON SUBSEQUENT OUTCOME

Sixty babies, delivered over a six and a half year period, who had abs ent end diastolic frequency (AEDF) in the umbilical artery, were studi ed. Individually matched control pregnancies for gestational age, birt hweight, maternal clinical condition and date of delivery, in whom umb ilical artery recordings showed end diastolic frequency, were also stu died. Matching was achieved in 36 cases. Neonates from case pregnancie s showed no increase in necrotising enterocolitis, intraventricular ha emorrhage, pneumothorax, neonatal death or bronchopulmonary dysplasia. However, they were significantly less Likely to require ventilation f or respiratory distress syndrome (P=0.02). Although AEDF indicates a f etus under vascular stress, this finding alone will include a spectrum of response in the baby, from the well compensated to the irreversibl y damaged. Delivery at different points in the deteriorating fetal env ironment may explain discrepant study results. This intrauterine stres s, by increasing fetal corticosteroid and thyroid hormones, may accoun t for enhanced lung maturity. Predictions of neonatal course need to b e based on more comprehensive awareness of fetal status.