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CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Antepartum Fetal Assessment

Poster Session 3

(971) Abnormal umbilical artery Doppler studies in fetal macrosomia: What do they mean?

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
Large for gestational age neonates are associated with poorer neonatal outcomes. Umbilical artery Dopplers studies (UADS) are noninvasive tests that evaluate vascular resistance and perfusion which. They are commonly used for pregnancies with fetal growth restriction, however their utility in suspected macrosomic fetuses (SMF) is unknown. We aimed to evaluate the association between abnormal umbilical artery Doppler studies (UADS) and perinatal outcomes in suspected macrosomic fetuses (SMF).

Study Design:
This retrospective cohort study included singleton pregnancies ≥36 weeks with SMF, defined as EFW ≥90th percentile by Hadlock. Cases with fetal anomalies, aneuploidy, or multiple gestation were excluded. SMFs were categorized by UADS: normal vs abnormal, defined as elevated systolic/diastolic ratio or pulsatility index >95th percentile. The primary outcomes were 1 & 5 minute APGAR scores, NICU admission, arterial cord gas pH and base deficit, hyperbilirubinemia, hypoglycemia, or neonatal death. Multivariable logistic regression analyses were performed using Chi-Square/Fisher Exact Tests and t-tests.

Results:
Of the 447 patients with SMF, 14 (3.1%) had abnormal UADS. More than 70% (n=10, 71.4%) of patients with abnormal UADS experienced any adverse neonatal outcome compared to 45.3% (n=433) of patients with normal UADS (p = 0.05). In individual adverse neonatal outcomes, hyperbilirubinemia (50.0% versus 11.0%, p=0.0005), hypoglycemia (28.6% versus 8.6%, p=0.03), and mean cord gas base deficit (5.8± 3.3 versus 4.0± 3.0, p=0.04) were significantly elevated in those with abnormal UADS. Respiratory distress was also higher in the abnormal UADS group (28.6% versus 15.8%, p=0.26), but not significantly.

Conclusion:
Among SMF, abnormal UADS are associated with an increased risk of any adverse neonatal outcome by 26%. This may be due to placental insufficiency related to increased demand. Our numbers are small and further studies to assess if UADS may be useful in identifying higher-risk SMFs are needed to clarify the association.