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Poster Session 3

Category: Ultrasound/Imaging

Poster Session 3

(954) Fetal Doppler Severity and Outcomes in Pregnancies Complicated by Early Onset Growth Restriction and Preeclampsia

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Scott Infusino, MD (he/him/his)

Fellow
Cincinnati Childrens Hospital Medical Center
Cincinati, Ohio, United States

Coauthor(s)

JL

Jeanette M. Larson, MD

Medical Student
University of Wisconsin Hospitals and Clinics
Madison, Wisconsin, United States
NG

Natalia Gontarczyk Uczkowski, MPH

University of Wisconsin School of Medicine and Public Health, Department of Obstetrics and Gynecology
Madison, Wisconsin, United States
AG

Amy Godecker, PhD

Statistician
University of Wisconsin School of Medicine and Public Health, Department of Obstetrics and Gynecology
Madison, Wisconsin, United States
Jacquelyn H. Adams, MD, MSCI

Assistant Professor
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin, United States
JI

J. Igor Iruretagoyena, MD, MS

University of Wisconsin Hospitals and Clinics
Madison, Wisconsin, United States

Objective:
To determine if fetal Doppler severity and progression, as well as pregnancy outcomes, in early onset fetal growth restriction (FGR) are impacted by preeclampsia.

Study Design:
This was a retrospective cohort study from 2017 to 2023 evaluating singleton, nonanomalous pregnancies with a diagnosis of early onset FGR (< 32 weeks) who underwent serial fetal Doppler evaluation. Doppler evaluation included umbilical artery (UA) pulsatility index (PI), characterization of UA end diastolic flow (forward, absent, or reversed), and characterization of the ductus venosus (DV) a-wave (forward, absent, or reversed). Pregnancy outcomes were also collected.

Results:
There were 517 patients that met inclusion criteria. Sixteen percent (n=85) of pregnancies with early onset FGR developed preeclampsia. Patients with a diagnosis of both FGR and preeclampsia were more likely to deliver at an earlier gestational age (32.3 vs 37.6 weeks, p< 0.01) and had a shorter interval from diagnosis of FGR to delivery (37.4 vs 80.7 days, p< 0.01). Pregnancies with FGR and preeclampsia had a significantly higher Doppler severity at diagnosis of growth restriction and at evaluation before delivery (Table 1). A subgroup of eight patients were identified with severe preeclampsia and growth restriction with reversed umbilical artery Doppler (or late DV changes) that delivered before 28 weeks’ gestation (Table 2). One pregnancy was complicated by stillbirth, while the remaining were delivered for non-reassuring fetal status or Doppler findings. Five of these pregnancies were complicated by a neonatal or infant death.

Conclusion:
Pregnancies complicated by both early onset fetal growth restriction and preeclampsia were more likely to have a higher severity of Doppler abnormalities at time of diagnosis and delivery, earlier gestational age at delivery, and shorter interval to delivery. Patients with severe preeclampsia and growth restriction with reversed UA Doppler had particularly poor outcomes. This information can help providers manage these complex pregnancies and adequately counsel patients.