OUTCOME OF 88 PREGNANCIES WITH ABSENT OR REVERSED END-DIASTOLIC BLOOD-FLOW (ARED FLOW) IN THE UMBILICAL ARTERIES

Objectives: to investigate both perinatal and postneonatal morbidity a nd mortality in fetuses with absent or reversed end-diastolic flow (AR ED flow) in the umbilical artery. Study design: A 5 year prospective f ollow-up of 88 fetuses with ARED flow. Results: Sixteen stillbirths, 1 6 neonatal deaths, six postneonatal deaths and one death at 2 years of age were noted. Out of the 42 fetuses born alive, 36 showed a normal neurological development whereas six were mentally handicapped. Advers e prognosis was more frequently found in the group with absent end-dia stolic flow at first examination and then reversed flow until delivery , compared to the groups of always absent or always reversed end-diast olic flows. Conclusions: Prompt delivery is recommended in these high- risk pregnancies in order to prevent long-term sequelae, obviously dep ending on the local limits of viability. Further studies appropriately designed for assessing long-term neurodevelopment of fetuses with ARE D flow, although demanding, are mandatory. (C) 1998 Elsevier Science I reland Ltd.