Abnormal Umbilical Doppler Findings in Trisomy 18

Clinical Significance and Management

The combination of abnormal umbilical artery Doppler and fetal growth restriction should prompt consideration of chromosomal abnormalities, including trisomy 18, as recommended by the American College of Radiology and the American College of Obstetricians and Gynecologists 1, 2
When abnormal umbilical artery Doppler is detected, especially in early gestation or in combination with structural abnormalities, chromosomal testing should be offered, according to the American Journal of Obstetrics and Gynecology 2, 3

The Society for Maternal-Fetal Medicine recommends that pregnant women be offered prenatal diagnostic testing with chromosomal microarray analysis (CMA) when unexplained isolated fetal growth restriction is diagnosed at less than 32 weeks of gestation, with a strength of evidence based on expert opinion 3
The presence of abnormal umbilical artery Doppler in combination with structural abnormalities significantly increases the likelihood of chromosomal abnormalities, including trisomy 18, as reported by the American Journal of Obstetrics and Gynecology 2