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Absent umbilical arterial end diastolic flow

An absent end diastolic flow (AEDF) in the umbilical artery Doppler assessment is a useful feature which indicates underlying fetal vascular stress if detected in mid or late pregnancy. It is often classified as Class II in severity in abnormal umbilical arterial Dopplers 9.

Pathology

The presence of absent end diastolic flow (AEDF) can be normal in early pregnancy (up to 16 weeks). In mid to late pregnancy it usually occurs from placental insufficiency 7-8. Flow in the umbilical artery(ies) should be in the forward direction in normal circumstances. If the placental resistance increased for some or other reason, the diastolic flow may reduce, then become absent and finally go into reverse.

Associations

Radiographic features

Doppler ultrasound

The umbilical arterial velocity is seen reducing to zero at the end of diastole.

Treatment and prognosis

The situation carries an increased fetal and neonatal mortality as well as an increased incidence of long-term permanent neurologic damage 5.

Approximately a 3rd of cases may improve with bed rest. Often it is recommended that close follow-up and / or expeditious delivery should be contemplated 7.

See also

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