Information on Foetal Doppler

How placental dysfunction is is reflected in Doppler indices?? Ans:- As diagnostic tools 1) elevated umbilical artery blood flow resistance 2) and /or middle cerebral artery brain sparing provide evidence of placental dysfunction.

In the fetal compartment elevation of the umbilical artery Doppler index is observed when approximately 30% of the fetal villous vessels are abnormal.

What does “Absence or even reversal of umbilical artery end diastolic velocity: warns us in an whispering voice?? Ans:- Such changes may  occur when 60% to 70% of the villous vascular tree is damaged. Therefore, the benefit of umbilical artery Doppler , umbilical artery Doppler , when used in conjunction with standard antepartum testing was associated with a decrease  of up to 38% in perinatal mortality antenatal admissions, inductions of labor and cesarean deliveries for fetal distress in labor in women considered at high risk.

What other in formations we receive from Umbilical vessels??  Ans:-Development of umbilical venous pulsations in fetuses with absent end diastolic velocities in the umbilical artery was associated with a fivefold increase in mortality. Researchers have demonstrated that gestational age at  the onset maternal hypertension and the development of pulsations in the umbilical venous velocities were significantly correlated with the interval of time between diagnosis and delivery for late decelerations for the FHR.

In summary Doppler evaluation of the umbilical cerebral and precordial vessels (if possible) in  the growth restricted fetus informs us :->1)  important diagnostic and prognostic information of in utero foetus. Fetal academia and the risk of stillbirth are high with progressive elevation of venous Doppler indices.

Risk factor based Screening protocols : Not only Doppler studies but other methods of foetal surveillance should also be used to achieve maximum information about feta oxygenation and hypoxemia .Advancing Doppler abnormalities indicates acceleration of disease and requires increased frequency of fetal monitoring. In growth restricted fetuses, Doppler evaluation is complementary to all other surveillance modalities.