3.9 Doppler

Umbilical artery (UA) Doppler is recommended when there is a reduction in growth velocity, the fetus is SGA/FGR according to EFW by scan, or the woman has been referred for decreased fetal movements.

A normal UA Doppler does not exclude abnormal placental function in the SGA/FGR infant.

SGA/FGR infants with normal UA Doppler and higher risk of morbidity include those with:

  • Abnormal middle cerebral artery (MCA) Doppler studies (5,6).
  • Abnormal ratio of MCA / UA Doppler indices [cerebro-placental ratio (CPR)] (5,6).
  • Abnormal uterine artery Doppler studies at time of diagnosis of SGA/FGR (6,7).
  • Extreme SGA/FGR with estimated fetal weight <3rd centile (8).

        (These babies can be considered to have growth restriction)

5 – Cruz-Martinez, R., Figueras, F., Hernandez-Andrade, E., Oros, D., & Gratacos, E. (2011) Fetal brain Doppler to predict cesarean delivery for nonreassuring fetal status in term small-for-gestational-age fetuses. Obstetrics and Gynecology, 117(3), 618-626. doi:10.1097/AOG.0b013e31820b0884References

6 – Severi, F. M., Bocchi, C., Visentin, A., Falco, P., Cobellis, L., Florio, P., . . Pilu, G. (2002) Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound in Obstetrics and Gynecology, 19(3), 225-228. doi:10.1046/j.1469-0705.2002.00652.x

7 – Ghosh, G. S., & Gudmundsson, S. (2009) Uterine and umbilical artery doppler are comparable in predicting perinatal outcome of growth-restricted fetuses. BJOG: An International Journal of Obstetrics and Gynaecology, 116(3), 424-430. doi:10.1111/j.1471-0528.2008.02057.x

8 – Savchev, S., Figueras, F., Cruz-Martinez, R., Illa, M., Botet, F., & Gratacos, E. (2012) Estimated weight centile as a predictor of perinatal outcome in small-for-gestational-age pregnancies with normal fetal and maternal Doppler indices. Ultrasound in Obstetrics and Gynecology, 39, 299-303. doi:10.1002/uog.10150