OC113: Abnormal ductus venosus Doppler independently predicts poor perinatal outcome in fetuses delivered for severe early placental insufficiency: a multicenter cohort study

Objective: Longitudinal measurements of quantitative flow (QF) could clarify compensatory mechanisms to fetal hypoxia, and suggest predictive factors of fetal decompensation and adverse outcome. Our aims were to analyse in IUGR fetuses longitudinal changes of QF in umbilical vein (UV), ductus venosus (DV) and left cardiac output (LCO) and to identify which cardiovascular pattern is more frequently associated with adverse outcome. Methods: In 33 IUGR fetuses, two consecutive examinations were retrospectively considered: the last scan (LAST) within 3 days before delivery and the previous exam (FIRST) within 8 days before LAST. Doppler QF was measured at three different sites: intraamniotic UV, DV and ascending aorta, according to a standardized methodology. QF changes were compared between alive babies and perinatal deaths. A subset of viable fetuses delivered between 28 to 32 weeks was separately considered. QF changes suggestive of fetal decompensation (UV flow reduction, DV dilatation, DV flow increase, LCO reduction) were considered as a variation >10% from FIRST and LAST examination. Timing of delivery was independently decided by the clinical staff. Results: The gestational age at delivery was 29 ± 3.5 weeks (mean ± SD); the weight at delivery was 880 ± 450 g (mean ± SD).