Research Implications-
Thus by considering above all findings we could suggest that ,Retrograde flow in AoI might be considered as an additional trigger for delivering IUGR fetuses between 30-34 weeks with AREDF in Umbilical artery and might be considered as an additional clinical parameter in the routine assessment of hemodynamic ally compromised growth-restricted fetuses.
Hence suggesting an opportunity to combine the Umbilical artery ,Aortic isthmus and DV Doppler flows in minimizing the adverse perinatal outcome which should be studied further ..
Gratacos et al [16] suggested that before 26 weeks and after 28 weeks, gestational age alone is the strongest predictor of perinatal mortality in early-onset IUGR. However, in the group between 26 and 28 weeks of gestation, the DV may provide useful information and allow stratification between high and low risks of perinatal mortality. As by the staging classification given by Gratacos et al[12] ,AEDF in umbilical artery and reversal in AoI suggests severe placental insufficiency while REDF in umbilical artery and abnormal DV PI suggest suspicion of fetal acidosis
Also suboptimal neurological development was found among children who had net reversed diastolic flow in the AoI antenatally[8] ,Considering all this it might be better to consider AEDF/REDF in UA and reversal of flow in AoI as a sensible marker for delivering the IUGR fetus especially between 30-34 weeks of gestation before the fetal compensatory mechanisms to hypoxia fail .