We retrospectively examined the perinatal course of 12 fetuses observed having distinguished or reversed end-diastolic flow in the umbilical artery or the fetal descending aorta.
Eleven of the 12 fetuses were delivered by Caesarian section due to fetal distress with Apgar scores of less than 7 points at 1 minutes.
In 7 of these cases, we observed reversed flow in the umbilical artery or the fetal descending aorta. Of these 7 cases, there were 4 cases were delivered with severe asphyxia with Apgar scores of less than 5 points at 1 minute. Two of these cases died within 7 days after delivery.
In the 5 cases who were observed having only distinguished flow, none died in utero nor after delivery. Three were at less than 5 Apgar points at 1 minute, but at 5 minutes were at 8.4 ± 1.7 (mean ± SD), compared with those having reversed end-diastolic flow, which were at 7.4 ± 1.3 at 5 minute.
As the outcome of neonates observed with reversed flow in the umbilical artery or descending aorta is poor, an immediate delivery is necessary. Moreover, before the 33rd gestational week, the outcome of neonates observed the reversed flow is quite poor. We must consider termination of the pregnancy, when only distinguished end-diastolic flows are observed.
We found Doppler flow velocimetry to be useful tool in diagnosis of pregnancy termination, especially in cases before the 33rd gestational week.