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Fetal Doppler Assessment in Pregnancy
Fetal Doppler Assessment in Pregnancy
PREGNANCY
BY
BODE ADEWUNMI
INTRODUCTION
• The use of Doppler in perinatal medicine can be
divided into two component
• Uterine artery Doppler(uteroplacental Doppler and
fetal arterial and venous Doppler
• Uterine artery Doppler is usually performed as
screening test
• Fetal Dopplers are used as an adjunct to diagnosing
the severity of fetal compromise in potentially hypoxic
conditions and are often performed serially in fetus
that is though to be high risk.
UMBILICAL ARTERY
•UB artery waveform represents placenta vascular resistance
•Should be regarded as indicator of resistance in the feto-
placental vascular bed
•UB artery circulation is a low impedance circulation with increase
amount of end-diastolic flow with advancing gestation .
•Increase in end-diastolic flow that is seen with advancing
gestation is a direct result of increase in the number of tertiary
stem villi that takes place with placental maturation.
•Disease that obliterate small muscular arteries in the placenta
tertiary stem villi result in a progressive decrease in end diastolic
flow in the UB artery Doppler waveform until absent and then
reverse flow during diastole is noted
•Reversed diastolic flow in UB artery represents advanced
stage of placental compromise.
•Absent or reversed end-diastolic flow in the umbilical artery
is commonly associated with severe intrauterine growth
restriction (IUGR) and oligohydramnios.
•Umbilical artery waveforms can be obtained from a free loop
of umbilical cord, in most cases near the placental insertion
where movement artifact is les.
•Angle should be less than 600.
•From 16wks onwards ,the UA should show positive End
Diastolic velocity.
•At 30-34wks delivery decisions in a growth restricted baby
may be made on the basis of amniotic fluid ,fetal
movements ,CTG and umbilical artery Doppler.
•From 16wks onwards ,the UA should show positive
End Diastolic velocity.
•At 30-34wks delivery decisions in a growth restricted
baby may be made on the basis of amniotic fluid ,fetal
movements ,CTG and umbilical artery Doppler.
Note; that absents or reversed umbilical artery end-
diastolic flow suggests more detailed investigation in
units where fetal Doppler is available or close
observation and investigation using a
cardiotocography.
*Three major abnormalities of UA
1. Raised resistance, pulsatality index PI or resistance
index >95 percentile
MIDDLE CEREBRAL ARTERY.