{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:25:10Z","timestamp":1790101510840,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2009,8,24]],"date-time":"2009-08-24T00:00:00Z","timestamp":1251072000000},"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 &amp; Gyne"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the outcome of growth\u2010restricted fetuses with absent or reversed end\u2010diastolic flow (ARED) in the umbilical artery delivered on fetal indication before 30 gestational weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 1998 and 2004, 42 fetuses with intrauterine growth restriction (IUGR) and ARED in the umbilical artery were delivered liveborn by Cesarean section on fetal indication before 30 gestational weeks. The median gestational age at delivery was 27 + 1 (range, 24 + 4 to 29 + 5) weeks. An additional four fetuses died  <jats:italic>in utero<\/jats:italic> at a median gestational age of 24 + 2 (range, 23 + 5 to 25 + 4) weeks. Neonatal morbidity, infant mortality and major neurological morbidity of liveborn infants were compared with those in two control groups: all 371 liveborn infants delivered at &lt; 30 weeks during the corresponding time period (Group A) and a subset of these, 42 matched infants without IUGR (Group B).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010two fetuses (7%) were delivered within 48 h of the occurrence of ARED (25 absent, seven reversed end\u2010diastolic flow). The remaining 10 fetuses (five absent, five reversed end\u2010diastolic flow) were monitored for a median of 6.5 (range, 3\u201318) days before delivery. One infant died in the neonatal period and three during the first year of postnatal life (2\u2010year survival 90%). The incidence of chronic lung disease was higher in the ARED Group than in Control Groups A and B (<jats:italic>P<\/jats:italic> = 0.001 and <jats:italic>P<\/jats:italic> = 0.03, respectively). There were no differences between the groups in the occurrence of necrotizing enterocolitis, cerebral hemorrhage or retinopathy of prematurity. Cerebral palsy was diagnosed in 14% of the index group compared with 11% and 17% of Control Groups A and B (<jats:italic>P<\/jats:italic> &gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Very preterm growth\u2010restricted fetuses with umbilical artery ARED delivered on fetal indication, in most cases before the occurrence of severe changes in the ductus venosus velocity waveforms and\/or fetal heart rate tracings, showed high 2\u2010year survival and low morbidity. Copyright \u00a9 2009 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.7321","type":"journal-article","created":{"date-parts":[[2009,8,24]],"date-time":"2009-08-24T14:34:54Z","timestamp":1251124494000},"page":"288-296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Early intervention in management of very preterm growth\u2010restricted fetuses: 2\u2010year outcome of infants delivered on fetal indication before 30 gestational weeks"],"prefix":"10.1002","volume":"34","author":[{"given":"J.","family":"Brodszki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Morsing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Malcus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Thuring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Ley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Mar\u0161\u00e1l","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,8,24]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200204000-00005"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90466-2"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2003.10.014"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00591.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00590.x"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2002.00627.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.965"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1996.tb14164.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)90620-6"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00665.x"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016349609054684"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1914"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1906"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000253215.79121.75"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2007.26.5.555"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16809-8"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17821-0"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2002.020396"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70513-8"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.01.036"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-200206000-00004"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-200111000-00018"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-097X.2004.00532.x"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00661.x"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004310000680"}],"container-title":["Ultrasound in Obstetrics &amp; 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