ARTERIAL AND VENOUS DOPPLER VELOCIMETRY IN THE SEVERELY GROWTH-RESTRICTED FETUS AND ASSOCIATIONS WITH ADVERSE PERINATAL OUTCOME

Objective To evaluate the association between arterial and venous Dopp ler waveforms and adverse perinatal outcome in severe intrauterine gro wth restriction.Design Fetuses between 26 and 32 weeks' gestation with ultrasonographically estimated fetal weight below the 5th centile wer e included in this prospective study. The last Doppler measurements of the umbilical artery, ductus venosus, umbilical vein and middle cereb ral artery before delivery and adverse outcome parameters without gest ational age independence were used for statistical analysis. Adverse o utcome parameters were defined as the following: fetal demise or neona tal death in the first 30 days of life; 5-min Apgar score of < 7; intu bation at birth; retinopathy of prematurity; respiratory distress synd rome; necrotizing enterocolitis; stay in neonatal intensive care unit of more than 60 days; intraventricular hemorrhage; periventricular leu komalacia. Results Nineteen fetuses fulfilled the inclusion criteria. Perinatal death, low 5-min Apgar values and necrotizing enterocolitis were gestational age-independent adverse outcome parameters. Abnormal Doppler velocimetry of the ductus venosus was the only significant par ameter associated with perinatal death and low 5-min Apgar scores. Non e of the Doppler parameters predicted necrotizing enterocolitis. Concl usion Our data suggest that management of severely growth-restricted f etuses may be aided by the study of ductus venosus Doppler velocimetry .