Conclusion
To conclude, this study confirms previous observations that retrograde blood flow in the AoI is associated with adverse perinatal outcome, particularly intrauterine demise ,neonatal death ,RDS. Retrograde flow in AoI correlates significantly with abnormal flow in Umbilical artery,Middle cerebral artery and Ductus venosus. And even though the DV flow is normal adverse outcome might be suspected in fetuses with AEDF/REDF in UA and retrograde flow in AoI. Thus, retrograde flow in AoI might be considered as an additional trigger for delivering IUGR fetuses between 30-34 weeks with AREDF in Umbilical artery .However further large prospective studies and randomized controlled trials taking retrograde flow in aortic isthmus along with AREDF in UA as a trigger to deliver are required for evaluating immediate perinatal as well as long term neurological outcome .This might help to improve the surveillance protocols and perinatal as well as long term neurodevelopemental outcome in IUGR fetuses .
Disclosure of interests :  The authors report no financial, personal, political, intellectual or religious conflict of interest
Contribution to authorship:
DR. SHALAKA ARUN BANSODE - Principal author
I being the Principal author has carried out this study after planning with my co authors and carried out the case collection ,study analysis and writing up of my work .