ImpactU Versión 3.11.2 Última actualización: Interfaz de Usuario: 16/10/2025 Base de Datos: 29/08/2025 Hecho en Colombia
EP15.13: Association between low umbilical vein flow and subsequent low growth trajectory of adequate‐for‐gestational fetuses between 31–36 weeks and birth
The aim of this study was to evaluate the association between normalised umbilical vein flow by fetal weight (NUV) and Doppler parameters at 31 and 36 weeks with subsequent low growth trajectory (LGT) defined as below the 20 centile according to the change in growth centile between the 31 third trimester scan and birthweight, in low risk population. A cohort of 47 term AGA fetuses with EFW at 31 and 36 weeks, and recorded BW was created, to determine the relative change in customised weight between 31 weeks and birth. Inclusion criteria were: (i) an EFW> 10th centile and (ii) an umbilical artery Doppler pulsatility index (PI) below the 95th centile. Umbilical artery (UA) Middle cerebral artery (MCA) and mean uterine artery (UtA) pulsatility index (PI) was calculated. The NUV (mL/min) was also calculated at a free-floating loop as reported elsewhere. The association between NUV and fetal Doppler parameters at 31 to 36 weeks and the risk of LGT was analysed by binomial logistic regression. We also examined whether a LGT in fetuses was associated with operative deliveries performed for non-reassuring fetal status. A total of 11 (23%) cases qualified for LGT and 3 (8.5%) cases were SGA at birth. Multivariable analysis showed that significant contributions to prediction of LGT were provided by NUV (p = 0.047) (Nagelkerke R2= 26.5) at 31 weeks, NUV (p = 0.028) (Nagelkerke R2= 47.2) at 36 weeks. Other Doppler parameters evaluated such as UA, MCA, CPR or UtA Doppler, not showed statistically significant differences. Of 33 who labored, operative delivery for suspected fetal compromise was performed in 4/8 (50%) cases where LGT, and 4/25 (16%) where controls (p = 0.05). NUV assessment may be of value in detecting at third trimester routine scan between 31 to 36 weeks, the AGA pregnancies that are at risk of LGT due to subclinical placental insufficiency.