ABSTRACT
Background: This study was conducted to decide the best line of management of intrauterine growth restricted fetuses with absent end-diastolic blood flow in umbilical artery. This was guided by studying short term morbidity and mortality among these infants. Patients and methods: We conducted a prospective study which included seventy-four pregnant women, at 32-36 weeks gestation, with intrauterine growth restriction, (birth weight <10th percentile), with absent end-diastolic blood flow in umbilical artery, biophysical profile 8/10 and negative contraction stress test. Patients were divided into two groups, group A and group B. Group (A), included 34 patients, was subjected to termination within 24 hours form recruitment and group (B), included 40 patients, was subjected to expectant management. Setting: Woman's Health Center, Assiut University. Results: In group A 6 infants died in neonatal period (17.6%), in group B, 3 fetuses died in utero (7.5%) and 4 infants died in neonatal period (10%). The Cesarean delivery rate was significantly higher in group B than group A (82.5% vs. 73.5%). Referral to pediatric care unit was significantly higher in group A than group B (85.3% vs. 77.5%). Neonatal morbidity was significantly higher in group a than group B. Conclusions: There was no significant difference in perinatal deaths between expectant and active management protocols. Neonatal morbidity was significantly lower in group with expectant management.
Key words: Expectant management, intrauterine growth restriction, blood flow.