First‐trimester reversed end‐diastolic flow in the umbilical artery is not always an ominous sign

Abstract

K E Y W O R D S:

Reversed end‐diastolic flow in the umbilical artery at 10–14 weeks of gestation is associated with absent pulmonary valve syndrome

“…However, the ventricular septal defect in the remaining fetus with trisomy 18 in our cohort is unlikely to have caused the REDF. In this case it is more likely that the increased vascular impedance was due to a decrease in trophoblast invasion, as has been demonstrated in previous studies in aneuploid fetuses16 and in fetuses that developed early‐onset growth restriction in the further course of pregnancy9.…”

“…REDF in the umbilical artery between the 10 th and 14 th weeks of gestation is very rare; a total of 23 cases have been reported so far2–9. The associated conditions included 14 cases of chromosomal anomalies (six trisomy 18; three trisomy 13; five other aneuploidies), two cases with isolated cardiac defects (one pulmonary atresia; one atrioventricular septal defect), one VACTERL association and one early twin‐to‐twin transfusion syndrome, and there were five anatomically normal fetuses, of which two developed early onset growth restriction.…”

“…Between the 11 th and 14 th weeks, positive diastolic flow emerges and remains detectable from then onwards1. Reversed end‐diastolic flow (REDF) in the umbilical artery in the first trimester is very rare and previous reports have found a strong association with chromosomal anomalies, fetal heart defects, early onset growth restriction and an unfavorable prognosis in affected fetuses2–9. Here, we report on five further cases of REDF in the umbilical artery detected in first‐trimester pregnancies, and describe their associated anomalies.…”

Doppler Ultrasound of the Umbilical Artery: Clinical Application

“…43 While an AEDV flow before the 15 th week is a normal physiological finding, 44 a REDV flow during the 1 st trimester is associated with chromosomal abnormalities, fetal cardiovascular defects, and significant mortality. [45][46][47][48][49] However, as stated by Bellver et al, 50 the latter "is not always an ominous sign. "…”