Umbilical Venous Doppler Velocimetry to Supplement Conventional Arterial Doppler to Assess Third Trimester Fetal Growth Restriction

Abstract

Objectives: To evaluate whether the use of umbilical venous Doppler velocimetry and volume flow measurements in near-term pregnancies with suspected fetal growth restriction (FGR) are predictive of immediate perinatal outcome.
Methods: Consecutive cases with suspected FGR after 28 weeks of gestation were prospectively recruited over 12 months. The fetuses with and without confirmed FGR, as well as normally growing controls, were compared. Fetuses with significant congenital abnormalities were excluded from the analysis.

Results: A total of 62 confirmed FGR fetuses were compared with a control group of 58 normally growing fetuses. Total umbilical venous flow (TUVF) was significantly lower in the fetuses confirmed to have FGR (198.6 ml/min; standard deviation [SD], 35.3 ml/min) as compared to those without (263.9 ml/min; SD, 50.8 ml/min; p<0.001), but the TUVF per unit birth weight did not differ between the two groups (87.6 ml/min/kg vs 83.1 ml/min/kg). However, the mean TUVF per unit weight was significantly lower (73.2 ml/min vs 87.9 ml/min) for those with a positive composite neonatal morbidity score as compared to those with a negative score.
Conclusion: Umbilical venous volume flow studies could supplement prediction of immediate morbidity in growthrestricted fetuses.