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Summary: We present a case of a heroin addict in whom Doppler flow study on the umbilical artery showed absent end diastolic flow at 29 weeks* gestation by ultrasound. Following methadone administration, the mother's withdrawal symptoms were controlled, the fetal diastolic flow returned, and there was a normal systolic/diastolic ratio. Delivery at 32 weeks' gestation by ultrasound resulted in a surviving infant who required treatment with phenobarbitone and morphine after birth to control withdrawal symptoms.