{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:32:38Z","timestamp":1790609558374,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2021,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To investigate if the extent of absent end\u2010diastolic flow (AEDF) on umbilical artery (UA) Doppler velocimetry predicts pregnancy outcome.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a retrospective observational study based on data from 25\u2009000 Doppler examinations of UA flow performed between 1998 and 2017 at the Blood Flow Laboratory, Level III Perinatal Center, Lund, Sweden. All pregnancies with AEDF in the UA were identified, and the duration of AEDF as a proportion of the total duration of the cardiac cycle (T\n a<\/jats:sub>\n \/T\n tot<\/jats:sub>\n ratio) was measured in digital images of the Doppler spectrum recorded at the last examination showing AEDF before delivery. Clinical data on pregnancies and neonatal outcomes were extracted from the regional perinatal database and the hospital patient records. The predictive performance of the T\n a<\/jats:sub>\n \/T\n tot<\/jats:sub>\n ratio for intrauterine death and any (intrauterine or postnatal) death was assessed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 170 fetuses (122 (72%) singletons and 48 (28%) twins) were included in the study. Median gestational age at birth was 189.5\u2009days (range, 163\u2013279\u2009days) (i.e. 27\u2009+\u20090\u2009weeks (range, 23\u2009+\u20092 to 39\u2009+\u20096\u2009weeks)), birth weight was 650\u2009g (range, 320\u20133326\u2009g) and deviation from expected birth weight (standard deviation score) was \u20132.975 (range, \u20136.38 to 0.69). There were 15 (9%) intrauterine and 26 (15%) postnatal deaths. The principal outcome variables and their relationship with Doppler velocimetry results did not differ significantly between singletons and twins, giving a rationale for using the T\n a<\/jats:sub>\n \/T\n tot<\/jats:sub>\n ratio in the total study group. Mean T\n a<\/jats:sub>\n \/T\n tot<\/jats:sub>\n ratio was 0.42\u2009\u00b1\u20090.08 and 0.34\u2009\u00b1\u20090.08 in stillborn and liveborn fetuses, respectively (\n P<\/jats:italic>\n \u2009=\u20090.002). For fetuses examined before 30\u2009weeks' gestation, a T\n a<\/jats:sub>\n \/T\n tot<\/jats:sub>\n ratio cut\u2010off of 0.30 predicted intrauterine death with 92% sensitivity and a negative predictive value (NPV) of 98% (area under receiver\u2010operating\u2010characteristics curve (AUC), 0.74) and predicted any death with 83% sensitivity and a NPV of 85% (AUC, 0.66).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In fetuses with AEDF in the UA, duration of absent flow for at least 30% of the total cardiac cycle length might predict the risk of fetal demise, even when assessed before 30\u2009weeks' gestation. This finding is particularly relevant to growth\u2010restricted fetuses. After evaluation in further studies, the extent of AEDF might facilitate obstetric decision\u2010making in very preterm growth\u2010restricted fetuses. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.23541","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T16:22:18Z","timestamp":1605716538000},"page":"369-376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Extent of absent end\u2010diastolic flow in umbilical artery and\u00a0outcome of pregnancy"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0692-2941","authenticated-orcid":false,"given":"M.","family":"Kinoshita","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona Barcelona Spain"},{"name":"Clinical Sciences Lund, Department of Pediatrics Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Thuring","sequence":"additional","affiliation":[{"name":"Clinical Sciences Lund, Department of Obstetrics and Gynecology Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-6070","authenticated-orcid":false,"given":"E.","family":"Morsing","sequence":"additional","affiliation":[{"name":"Clinical Sciences Lund, Department of Pediatrics Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3837-6332","authenticated-orcid":false,"given":"K.","family":"Mar\u0161\u00e1l","sequence":"additional","affiliation":[{"name":"Clinical Sciences Lund, Department of Obstetrics and Gynecology Lund University Lund 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