RT Book, Section
A1 Gotsch, Francesca
A1 Cruciani, Laura
A1 Ghezzi, Fabio
A1 Ogge', Giovanna
A1 Yeo, Lami
A1 Romero, Roberto J.
A2 Fleischer, Arthur C.
A2 Toy, Eugene C.
A2 Lee, Wesley
A2 Manning, Frank A.
A2 Romero, Roberto J.
SR Print(0)
ID 1106705718
T1 DOPPLER INTERROGATION OF THE FETAL CIRCULATION
T2 Sonography in Obstetrics and Gynecology: Principles & Practice, 7e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071547727
LK obgyn.mhmedical.com/content.aspx?aid=1106705718
RD 2023/09/28
AB This  chapter  focuses  on  the  Doppler  interrogation  of  the  fetal  circulation.  Other  chapters  in  this  book  focus  on  Doppler  velocimetry  of  the  uterine  arteries  and  fetal  echocardiography.  Randomized  clinical  trials  have  demonstrated  that  Doppler  examination  of  the  umbilical  arteries  can  reduce  perinatal  mortality,  and  therefore  this  technique  is  no  longer  considered  investigational.  Moreover,  the  detection  of  an  abnormal  Doppler  velocimetry  of  the  umbilical  artery  allows  classification  of  small  for  gestational  age  (SGA)  fetuses  into  those  who  have  "placental  disease"  (defined  as  an  abnormal  umbilical  artery  Doppler  waveform)  and  those  who  have  other  conditions  that  may  be  responsible  for  their  small  size.  A  fraction  of  SGA  fetuses  are  diagnosed  at  term  and  often  do  not  have  any  abnormalities  of  the  umbilical  artery  Doppler,  but  may  have  alterations  of  the  cerebral  circulation  (anterior  cerebral  artery  or  middle  cerebral  artery).  Therefore,  practitioners  need  to  be  familiar  with  the  sampling,  interpretation,  and  clinical  significance  of  these  vessels.  Similarly,  Doppler  examination  of  the  venous  system  (ductus  venosus,  inferior  vena  cava  (IVC),  and  umbilical  vein)  are  informative  of  cardiac  function  and  identify  a  fetus  at  risk  for  impending  in  utero  death.  Finally,  examination  of  the  peak  systolic  velocity  of  the  middle  cerebral  artery  has  become  important  in  the  assessment  of  fetal  anemia.  Therefore,  this  chapter  reviews  in  detail  the  anatomy,  physiology,  Doppler  waveform  morphology,  normal  ranges,  and  the  interpretation  of  an  abnormal  waveform  in  clinical  practice.