Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 2

Category: Ultrasound/Imaging

Poster Session 2

(536) Characteristics and outcomes of selective fetal growth restriction with intermittent absent end diastolic flow

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Juliana S. Gebb, MD

Associate Professor
Richard D. Wood Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States

Coauthor(s)

AJ

Alekhya Jampa, MD

Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
VB

Violetta Bakunina, BS

Clinical Research Assistant
Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
YZ

Yunliang Zhao, BA

Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
KB

Kiersten Barr, BS

Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
FB

Federica Bellusi, MD

Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
DF

Desiree Fiorentino, MBA, MD

Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
SD

Suzanne E. DeBari, BS, RDMS

Sonographer
Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
BC

Beverly G. Coleman, MD

Professor
Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment and Department of Radiology, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
Nahla Khalek, MD, MEd, MPH

Associate Professor, Clinical OBGYN in Surgery
Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States
Shelly Soni, MD

Associate Professor of Clinical Obstetrics and Gynecology in Surgery
Richard D. Wood, Jr Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Children's Hospital of Philadelphia, Pennsylvania, United States

Objective:
To describe characteristics of selective fetal growth restriction (sFGR) pregnancies with umbilical artery (UA) intermittent absent end diastolic flow (iAEDF) and compare outcomes in expectantly managed patients with iAEDF vs those with all forward flow (+EDF; Gratacos Type I), no forward flow (A/REDF; Gratacos Type II) and intermittent forward, absent, & reversed flow (iAREDF; Gratacos Type III).

Study Design:
Retrospective analysis of prospectively collected data from a single center monochorionic (MC) pregnancy registry. Records of patients with MC twins with sFGR evaluated 1/2013-12/2024 were reviewed. Patients with Twin Twin Transfusion Syndrome, Twin Anemia Polycythemia Sequence, & structural malformations were excluded. sFGR was defined by the Delphi criteria. Pregnancies were stratified by the UA of the FGR fetus: 1) +EDF; 2) iAEDF; 3) A/REDF; or 4) iAREDF. Pregnancy characteristics were compared, and outcomes were then compared in expectantly managed patients using Kruskall-Wallis, Mann-Whitney U, chi square, and Fisher’s exact test. p< 0.008 was statistically significant due to multiple comparisons.

Results:
Of 332 patients with sFGR, 115 (34.6%) had +EDF, 91 (27.4%) had iAEDF, 70 (21.1%) had A/REDF and 56 (16.9%) had iAREDF. Overall, gestational age (GA) at consult was lower in those with A/REDF compared to iAREDF (p=0.007) and fetal intervention was higher in patients with iAEDF, A/REDF and iAREDF compared to those with +EDF (all p< 0.001). In expectantly managed patients (n=196), median GA at delivery (weeks) was higher in patients with +EDF (32.5) & iAEDF (32.3) compared to A/REDF (27.4) & iAREDF (29.1) (+EDF vs iAEDF, p=0.160; +EDF vs A/REDF, p< 0.001; +EDF vs iAREDF, p< 0.001; iAEDF vs A/REDF, p=0.004; iAEDF vs iAREDF, < 0.001; A/REDF vs iAREDF, p=0.632). Total survivors to discharge were higher in those with +EDF compared to A/REDF (p< 0.001) but not compared to iAEDF (p=0.280) or iAREDF (p=0.150).

Conclusion:

In our cohort, patients with iAEDF had similar survival to patients with A/REDF and iAREDF but delivered at a later GA that was similar to those with +EDF.