Typical findings of a vascular IUGR occurring in early pregnancy, with already severe findings. In theory, US anomalies occur in the following order: Uterine notches -> asymmetrical IUGR -> umbilical Doppler with high RI -> fetal redistribution to preserve brain -> brain growth not preserved: symmetrical IUGR -> reverse diastolic flow in umbilical cord -> tricuspid insufficiency then elevated right atrium pressure: flat A wave on ductus -> cardiac failure -> intrauterine death. 

Identification of such situations is critical to monitor properly:

• maternal consequences on blood pressure and related CNS, kidney and liver disorders

• fetal demise with intrauterine fetal death