Reversed end-diastolic flow in first-trimester umbilical artery: An ominous new sign for fetal outcome

OBJECTIVE: The purpose of this study was to assess the fetal outcome of fir st-trimester pregnancies with reversed end-diastolic flow in the umbilical artery. STUDY DESIGN: Doppler studies in the umbilical artery were carried out in 2 970 consecutive pregnancies scanned at 10 to 14 weeks. RESULTS: We observed 11 (0.4%) cases of reversed end-diastolic flow. Of the se, an autosomal trisomy was shown in 7 and a congenital heart defect in 2 additional fetuses. Fetal demise was observed in 5 pregnancies, neonatal de ath was observed in 1, and termination of pregnancy was carried out in 4. O nly 1 fetus survived. CONCLUSIONS: Reversed end-diastolic flow in first-trimester umbilical arter y signals an ominous prognosis even with normal karyotype.