Abstract
CD and CD for NRFS alone or in combination with MCA Doppler was assessed by decision tree analysis. Results: Retrograde net blood flow in aortic isthmus was observed in 8.3% (14/169) of the cases and only within the group of fetuses with MCA vasodilation (PI < 5th centile). Among the overall study population, cases with reversed aortic isthmus blood flow were associated with a significantly higher risk of CD (85.7% vs. 36.8%, P < 0.001) and CD for NRFS (85.7% vs. 24.5%, P < 0.001) than those with antegrade blood flow. Decision tree analysis indicated that incorporation of aortic isthmus showed an additional predictive value to brain Doppler abnormalities. Among the group with MCA vasodilation, reversed aortic isthmus blood flow allowed discrimination of cases with high or moderate risk of CD (85.7% vs. 54.5%, P < 0.01) and CD for NRFS (85.7% vs. 40.9%, P < 0.05). Conclusions: Identification of aortic isthmus reversed blood flow identifies a subgroup of term SGA fetuses with middle cerebral artery vasodilation with the highest risk of emergency cesarean delivery for non-reassuring fetal status.
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