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 .