Reversed end-diastolic flow in first-trimester umbilical artery: An ominous new sign for fetal outcome

Objective: The purpose of this study was to assess the fetal outcome of first-trimester pregnancies with reversed end-diastolic flow in the umbilical artery. Study Design: Doppler studies in the umbilical artery were carried out in 2970 consecutive pregnancies scanned at 10 to 14 weeks. Results: We observed 11 (0.4%) cases of reversed end-diastolic flow. Of these, an autosomal trisomy was shown in 7 and a congenital heart defect in 2 additional fetuses. Fetal demise was observed in 5 pregnancies, neonatal death was observed in 1, and termination of pregnancy was carried out in 4. Only 1 fetus survived. Conclusions: Reversed end-diastolic flow in first-trimester umbilical artery signals an ominous prognosis even with normal karyotype. (Am J Obstet Gynecol 2001;185:204-7.)