Brief Answer:
Please proceed with another opinion from a tertiary fetal clinic

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. Umbilical artery is a vessel connecting the fetus with the placenta and supplies nutrition to the growing fetus.

2. The flow of blood in the umbilical artery is normally forwards in diastole. If there is no forward flow or reversal of flow direction in diastole then there is a possibility of associated fetal risk and this is a delicate situation.

3. Problems associated with such a finding includes the following.
(i) Risk of intrauterine growth restriction in mid pregnancy
(ii) Increased incidence of neonatal necrotizing enterocolitis in the fetus and thrombocytopenia in later pregnancy

4. Therefore there is a risk of fetal growth abnormalities and neurological problems in the developing fetus.

5. This is a class II severity problem and 33 percent pf patients might improve with rest and care and proceed to have a favorable outcome.

6. If there is reversal of umbilical arterial end diastolic flow then it becomes a grade II severity and termination is suggested due to more than 50 percent risk to fetus.

7. I suggest you take another opinion at a tertiary fetal clinic in your city and get the Doppler repeated if required. There is surely a risk in continuing the pregnancy however about 1 in 3 patients might have a good outcome in mild cases. Therefore a tertiary fetal clinic might have facilities to handle premature birth if you decide to continue with the pregnancy.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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