# Clinical significance of intermittently absent end-diastolic flow of the fetal umbilical artery on perinatal and neonatal outcomes

## TL;DR

The study compares outcomes of pregnancies with different types of umbilical artery Doppler flow and finds that intermittent absence has better outcomes than persistent absence.

## Contribution

The study identifies a prognostic distinction between intermittently and persistently absent umbilical artery Doppler flow, influencing management strategies.

## Key findings

- Intermittently absent end-diastolic flow had longer latency to delivery and better Apgar scores.
- All stillbirths occurred in the persistently absent flow group.
- Intermittent cases may be suitable for outpatient management, while persistent cases need closer monitoring.

## Abstract

The aim of this study was to compare the perinatal outcomes of pregnancies with intermittently absent end-diastolic umbilical artery Doppler flow and persistently absent flow, focusing on their implications for clinical management.

This retrospective cohort study was conducted at Basaksehir Cam and Sakura City Hospital between 2020 and 2023, and included 137 pregnancies diagnosed with either intermittently absent end-diastolic umbilical artery Doppler flow (n=38) or persistently absent flow (n=99). Demographic data, pregnancy complications, delivery details, and neonatal outcomes were analyzed.

The mean latency from diagnosis to delivery was statistically significantly longer in the intermittently absent end-diastolic umbilical artery Doppler flow group (15.6 days) than in the persistently absent flow group (7.88 days; p<0.0001). The intermittently absent end-diastolic umbilical artery Doppler flow group demonstrated better outcomes, with a higher gestational age at delivery and improved Apgar scores. Notably, although the difference was not statistically significant, all stillbirths (n=4) occurred in the persistently absent flow group. No intergroup differences were found in terms of intensive care unit admission or neonatal intubation.

This study highlights an important prognostic distinction between intermittently absent end-diastolic umbilical artery Doppler flow and persistently absent flow, with intermittently absent end-diastolic umbilical artery Doppler flow representing a less severe form of placental insufficiency. These findings provide valuable insights for optimizing antenatal surveillance strategies, suggesting that intermittently absent end-diastolic umbilical artery Doppler flow cases may be candidates for outpatient management, whereas persistently absent flow cases require more intensive monitoring.