OC25.04: Fetal umbilical artery Doppler end‐diastolic flow is associated with changes in maternal cardiovascular function: a three‐centre study using different techniques

We aim to assess whether fetal umbilical artery Doppler end diastolic flow (whether positive, absent or reversed) is associated with differences in maternal cardiac output (CO) and peripheral vascular resistance (PVR). This is a prospective study in three European Centres (London, Hasselt and Rome) on women ≥ 24 weeks with healthy pregnancies or affected by PE and/or FGR. CO and PVR were assessed using distinct non-invasive devices - inert gas rebreathing, continuous Doppler or impedance cardiography in both standing and lying position. CV parameters were normalised using Z-scores by comparing measurements from each technique with those from a population of normal pregnancies assessed with the same technique. Fetal umbilical artery Doppler PI was measured; and comparison of cardiovascular measurements were made between those cases with positive umbilical artery end diastolic flow (EDF) and those with negative or absent EDF. T-test was used to compare means. We included 214 participants with 192 patients with positive EDF and 22 patients with absent/negative EDF. CO was significantly lower in patients with absent/negative EDF in both standing (p = 0.03) and lying (p = 0.019) measurements. In patients with absent/negative EDF, PVR was significantly higher in both standing (p = 0.029) and lying (p = 0.022). In cases with absent/ reversed umbilical EDF there was significantly lower maternal CO and increased PVR. This may represent a link between deteriorating fetal Doppler and adverse changes in maternal cardiovascular state, raising the possibility of both of monitoring and therapeutic modulation of maternal cardiovascular status in situations of critical fetal hypoxia. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.