Short- and Long-Term Growth as a Function of Abnormal Doppler Flow in Growth-Restricted Fetuses

• Published in: Kardiologia prenatalna echo płodu Vol. 8; no. 1; pp. 76 - 79
• Main Authors: Ross, John W., Betz, Alexandria, Paglia, Michael J., Feng, Wen, Neubert, A. George, Mackeen, A. Dhanya
• Format: Journal Article
• Language: English
• Published: Sciendo 01.05.2018
• Subjects: estimated fetal weight; fetal growth restriction; long-term growth; short-term growth; umbilical artery systolic/diastolic ratios
• ISSN: 2353-8201; 2353-8201
• DOI: 10.1515/pcard-2018-0012

OBJECTIVES: To evaluate short- and long-term growth in fetuses with growth restriction (FGR) and elevated umbilical artery Doppler (UAD) systolic/diastolic (S/D) ratios. METHODS: In this prospective observational study, two UAD waveforms were obtained from each umbilical artery weekly and were classified as normal or abnormal. Fetal growth was assessed every 3 weeks. Short-term growth was calculated from the first visit with elevated ratios until next growth assessment. Results were grouped by number of initial elevated S/D ratios (maximum, 4). Long-term growth was evaluated by change in estimated fetal weight from diagnosis of FGR to birth weight. Fetuses were grouped by average number of elevated S/D ratios and compared to a reference population of growth restricted fetuses with normal testing. RESULTS: Of 241 fetuses evaluated, 105 demonstrated elevated S/D ratios. Short-term growth was impaired when fetuses had elevated S/D ratios. Long-term growth was affected when the average number of elevated S/D ratios was ≥1 per visit. Progressive 3 or 4 growth delay was noted as the average number of abnormal S/D ratios increased. CONCLUSIONS: Short- and long-term fetal growth are affected by elevated UAD S/D ratios. Fetuses with more abnormal values initially and those with a higher average of elevated values over pregnancy demonstrate decreased growth.