A 35wks POG, USG parameters more or less corresponding to POG. Doppler showing absent end diastolic flow Management:
In the above case scenario,POG is >34 weeks with absence of end diastolic flow so preferred management is Termination of pregnancy Management of pregnancy in deranged fetal doppler Earliest sign of fetal compromise is a raised S/D ratio in the Umblical aery flow, which warrants careful monitoring and follow up with NST and doppler and termination should be planned at 37 + weeks. An absence of diastolic flow is indicative of severe fetal compromise and requires intensive fetal monitoring with NST and frequent doppler upto 34 weeks or occurence of reversal of flow (whichever is earlier) after which pregnancy should be terminated. A reversal of diastolic flow is indicative of imminent fetal death (fetus is expected to die within 24-48 hours) requiring urgent termination, and therefore reversal occuring before lung maturity carries poor chances of fetal survival
Monitor till it becomes reverse diastolic flow or 37 weeks
Monitor till 37 weeks
Give steroids and wait for 48 hours
Plan for immediate termination
Intra Uterine Growth Restriction, Intrapaum and Antepaum Fetal Surviellance