Outcome of 88 pregnancies with absent or reversed end-diastolic blood flow (ARED flow) in the umbilical arteries

Montenegro, Nuno; Santos, Fátima; Tavares, Eugênio; Matias, Alexandra; Barros, Henrique; Leite, Luís

doi:10.1016/s0301-2115(98)00046-3

Cited by 29 publications

(20 citation statements)

References 14 publications

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“…[35][36][37] Our study extends the neurobehavioral effects of being SGA to term newborns with no signs of placental insufficiency, a subgroup of newborns traditionally considered to be at one end of the size spectrum of normal infants. Our findings challenge the concept that umbilical artery Doppler ultrasonography is a reliable tool to identify prenatally the constitutional term SGA infants at low risk.…”

Section: Discussionmentioning

confidence: 74%

Neurobehavior in Term, Small-for-Gestational Age Infants With Normal Placental Function

Orós²,

et al. 2009

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Section: Discussionmentioning

confidence: 74%

Neurobehavior in Term, Small-for-Gestational Age Infants With Normal Placental Function

Orós²,

et al. 2009

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“…Because of the low incidences of reverse flow cases, most authors have studied the effect of both reverse flow and absent enddiastolic flow velocity (often referred to an "ARED-flow") on the fetal outcome together as one entity [17]. Reverse flow was considered to be the last phenomenon preceding fetal death [5,12,23].…”

Section: Discussionmentioning

confidence: 99%

Comparison of perinatal outcome in fetuses with reverse or absent enddiastolic flow in the umbilical artery and/or fetal descending aorta

Ertan¹,

He²,

Tanriverdi³

et al. 2003

Journal of Perinatal Medicine

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The present study suggests that reversed flow should be seen as a particular clinical entity with higher incidences of perinatal and overall mortality, and severe intrauterine growth retardation (< 5. perc) compared to the absent enddiastolic flow group. The optimal timing of delivery in pregnancies complicated by highly pathological Doppler flow findings is only to be resolved in well-designed randomized, multicenter clinical trials.

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“…8 One study reported a five year follow up with six of 42 (14%) survivors of AREDFV having severe learning difficulties. 16 Moreover, Ley et al found that abnormal fetal aortic velocity wave forms were related with lower verbal and global IQ 17 and minor neurological dysfunction at age 7. 18 However, although abnormal fetal Doppler studies indicating redistribution of fetal blood flow preference to the brain predicted fetal death and growth retardation, 19 it was not independently associated with adverse neurological outcome at age 3 in a cohort born between 26 and 33 weeks of gestation.…”

mentioning

confidence: 99%

“…21 Previously, we reported the neonatal outcome of 122 high risk infants, 61 with AREDFV and 61 with forward flow who were matched for gestational age and sex. 16 These babies were born between 1985 and 1992, so there is now an opportunity to assess outcome at school age. We have traced this cohort and compared the outcome of groups of children defined by type of fetal umbilical artery flow pattern.…”

mentioning

confidence: 99%

Outcome at school age following antenatal detection of absent or reversed end diastolic flow velocity in the umbilical artery

Schreuder

McDonnell²,

Gaffney³

et al. 2002

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Aim: To determine whether fetal compromise, manifested by abnormalities of Doppler recordings of umbilical artery velocity waveforms in utero, is associated with neurodevelopmental or educational abnormalities at school age. Methods: A cohort of neonates born following high risk pregnancies had been previously identified for a study of the perinatal sequelae of absent (AEDFV) and reversed (REDFV) end diastolic flow velocities. Seventy six children were assessed at 5-12 years of age by a developmental paediatrician who was blinded to perinatal course and Doppler assessments. Forty children born following pregnancies with forward end diastolic flow velocities (FEDFV), were compared with 27 with AEDFV and nine with REDFV. Tests of cognitive, neurological, and sensory function were performed, and reports of behavioural and educational progress were obtained from parents and teachers. Results: There were no significant differences between FEDFV and AEDFV groups, but on tests of mental ability and neuromotor function the REDFV group had worse scores than either FEDFV or AEDFV. Comparing REDFV and FEDFV groups, the British Ability Scales general conceptual ability mean scores were 87.7 versus 101, and the Quick Neurological Screening Test mean scores were 32.8 versus 21.5. Conclusions: Absence of EDFV is well recognised as a marker of fetal compromise which is associated with acute perinatal sequelae. This study suggests it is not associated with adverse neurodevelopmental outcome. However, we found reversal of EDFV on antenatal assessment to be associated with a wide range of problems at school age, suggesting that REDFV represents intrauterine decompensation which may have adverse effects on the developing brain.

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Outcome of 88 pregnancies with absent or reversed end-diastolic blood flow (ARED flow) in the umbilical arteries

Cited by 29 publications

References 14 publications

Neurobehavior in Term, Small-for-Gestational Age Infants With Normal Placental Function

Neurobehavior in Term, Small-for-Gestational Age Infants With Normal Placental Function

Comparison of perinatal outcome in fetuses with reverse or absent enddiastolic flow in the umbilical artery and/or fetal descending aorta

Outcome at school age following antenatal detection of absent or reversed end diastolic flow velocity in the umbilical artery

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