A 35 wks POG, USG parameters more or less corresponding to POG. Doppler showing absent end diastolic flow. Management:
If >34 weeks POG, if fetus is at risk or likely to be at risk, Termination of the pregnancy is suggested. If <34 weeks POG, if fetus is at risk, can give steroids and wait for 48 hours for the lung maturity and surfactant production. In this case, Termination of pregnancy is suggested because - a) >34 weeks POG.b) Can progress to Reversal of diastolic flow, that causes imminent death of the fetus.
Monitor till it becomes reverse diastolic flow or 37 weeks
Monitor till 37 weeks
Give steroids and wait for 48 hours
Plan for termination
Intra Uterine Growth Restriction, Intrapaum and Antepaum Fetal Surviellance