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Severe Growth Restriction: No Correlation between Doppler Flussimetry and Fetal Condition

Abstract

Gaetani M, Naro ED, Loverro G, Pellegrino A, and Damiani GR

Optimal management of severe early fetal growth restriction presents one of the greatest challenges in obstetrics. At present, a combination of several different monitoring modalities is used, including arterial and venous Doppler ultrasonography plus assessment of short-term fetal heart rate variation, without consensus on which of these should trigger the decision to deliver. Pathological Doppler waveforms in the ductus venosus (DV) have been found to be associated with adverse out come. However it is not clear how long a fetus in utero can withstand changes in presence of altered flussimetry and which are , specifically, the effects related to them during extrauterine life. Optimal management of severe early fetal growth restriction presents one of the greatest challenges in obstetrics. At present, a combination of several different monitoring modalities is used, including arterial and venous Doppler ultrasonography plus assessment of short-term fetal heart rate variation, without consensus on which of these should trigger the decision to deliver.

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