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In the setting of fetal growth restriction, the guidelines of the Society for Maternal-Fetal Medicine recommend weekly Doppler US of the umbilical artery.
If the results of Doppler US remain normal, delivery is recommended at 38–39 weeks.
With decreased diastolic flow, antenatal testing (eg, nonstress tests, amniotic fluid measurement, and biophysical profile) is increased in frequency, Doppler US is performed weekly, and delivery is considered after 37 weeks.
When absent end-diastolic flow or reversed end-diastolic flow is present, corticosteroid therapy
is given in anticipation of preterm delivery, and Doppler US is performed two to three times per week, in addition to standard antenatal tests of fetal well-being.
Goal gestational ages for delivery are 34 weeks or more with absent end-diastolic flow and 32 weeks or more with reversed end-diastolic flow.