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Objectives: To determine the longitudinal trends and rates of conversion of normal to abnormal uterine (UtA), umbilical (UA) and middle cerebral artery (MCA) Doppler velocimetry throughout the third trimester in late-onset small-for-gestational-age (SGA) fetuses. Background: The finding of a small abdominal circumference should stimulate the sonographer to consider three possible: wrong date, normal small or abnormal small fetus. Methods: UtA, UA and MCA Doppler velocimetry was serially performed in a cohort of singleton consecutive late-onset SGA fetuses with normal Doppler values at diagnosis. The rate of conversion of normal to abnormal Doppler values was evaluated by survival analysis. Longitudinal trends were modeled by means of multilevel analysis. Results: A total number of study group included 150 SGA fetuses with normal Doppler upon diagnosis. Mean gestational age at inclusion and at delivery was 33.23 (SD 1.39) and 38.14 (SD 1.02) weeks, respectively. the longitudinal trends in UA PI and UtA PI showed no changes in contrast to MCA and CPR demonstrated a clear and progressive decrease in values from 7th week of follow up (37week of gestation) to delivery., mean MCA-PI 1.67 (SD 0.16) while mean CPR-PI 2.06 (SD 0.71) in all weeks of follow up for both. Conclusion: Late-onset SGA fetuses with normal Doppler velocimetry upon diagnosis show progression from 37 weeks’ gestation with worsening CPR followed by a decrease in MCA-PI.

Longitudinal Changes in Uterine, Umbilical and Fetal MCA Doppler Indices in Late Onset Small Fetuses (Doppler in Small Fetuses)