Skip to main content

Umbilical Doppler Velocimetry: Normative Data and Diagnostic Efficacy

  • Chapter
Doppler Ultrasound in Obstetrics and Gynecology

Abstract

The umbilical artery was the first fetal vessel to be evaluated by Doppler velocimetry and has since become the most widely investigated component of the fetal circulation. The attention paid to this vessel may be explained partly by its ready accessibility to Doppler interrogation, even without guidance by duplex imaging, and because it is a vital component of the fetal circulation, acting as the lifeline between the fetus and the placenta. Numerous studies have reported the methodogy of Doppler interrogation of the umbilical artery and have elucidated the factors that modulate the umbilical arterial Doppler indices under normal conditions. This chapter describes the procedure of Doppler sonography of the umbilical circulation and reviews the normative data on the umbilical arterial Doppler indices.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 269.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Maulik D, Yarlagadda P, Youngblood JP, Ciston P (1991) Comparative efficacy of umbilical arterial Doppler indices for predicting adverse perinatal outcome. Am J Obstet Gynecol 164:1434–1440

    PubMed  CAS  Google Scholar 

  2. Maulik D, Yarlagadda AP, Youngblood JP, Willoughby L (1989) Components of variability of umbilical arterial Doppler velocimetry: a prospective analysis. Am J Obstet Gynecol 160:1406–1412

    PubMed  CAS  Google Scholar 

  3. Schulman H, Fleischer A, Stern W et al (1984) Umbilical velocity wave ratios in human pregnancy. Am J Obstet Gynecol 148:985–990

    PubMed  CAS  Google Scholar 

  4. Nienhuis SJ, van Vugt JM, Hoogland HJ, Ruissen CJ, de Haan J (1988) Interexaminer variability of fetal Doppler velocity waveforms. Gynecol Obstet Invest 25:152–157

    PubMed  CAS  Google Scholar 

  5. Gudmundsson S, Fairlie F, Lingman G, Marsal K (1990) Recording of blood flow velocity waveforms in the uteroplacental and umbilical circulation: reproducibility study and comparison of pulsed and continuous wave Doppler ultrasonography. J Clin Ultrasound 18:97–101

    PubMed  CAS  Google Scholar 

  6. Davies JA, Lee A, Spencer JA (1990) Variability of continuous-wave Doppler flow velocity waveform indices from the umbilical artery. Obstet Gynecol 76:366–399

    PubMed  CAS  Google Scholar 

  7. Scherjon SA, Kok JH, Oosting H, Zondervan HA (1993) Intra-observer and inter-observer reliability of the pulsatility index calculated from pulsed Doppler flow velocity waveforms in three fetal vessels. Br J Obstet Gynaecol 100:134–138

    PubMed  CAS  Google Scholar 

  8. Brar HS, Medearis AL, De Vore GR, Platt LD (1988) Fetal umbilical velocimetry using continuous-wave and pulsed-wave Doppler ultrasound in high-risk pregnancies: a comparison of systolic to diastolic ratios. Obstet Gynecol 72:607–612

    PubMed  CAS  Google Scholar 

  9. Mehalek KE, Berkowitz GS, Chitkara U, Rosenberg J, Berkowitz RL (1988) Comparison of continuous-wave and pulsed Doppler S/D ratios of umbilical and uterine arteries. Obstet Gynecol 72:603–606

    PubMed  CAS  Google Scholar 

  10. Chan FY, Pun TC, Lee CP et al (1991) A comparative study of continuous-and pulsed-wave Doppler velocimetry in fetal and uteroplacental circulation. J Ultrasound Med 10:277–280

    PubMed  CAS  Google Scholar 

  11. Van Vugt JM, Ruissen CJ, Nienhuis SJ, Hoogland HJ, de Hann J (1988) Comparison of blood velocity waveform indices recorded by pulsed Doppler and continuous wave Doppler in the umbilical artery. J Clin Ultrasound 16:573–576

    PubMed  Google Scholar 

  12. Jorn H, Fendel H, Christ B (1991) Emn Vergleich zwischen einfachen Dopplermethoden (kontinuierlicher oder gepulster Doppler) and dem Duplex-System (Kombination von B-Bild and gepulstem Doppler). Z Geburtshilfe Perinatol 195:107

    PubMed  CAS  Google Scholar 

  13. Gaziano EP, Knox GF Wager GP, Bendel RP, Olson JD (1990) Pulsed Doppler umbilical artery waveforms: significance of elevated umbilical artery systolic/diastolic ratios in the normally grown fetus. Obstet Gynecol 75:189–195

    PubMed  CAS  Google Scholar 

  14. Abramowicz JS, Warsof SL, Arrington J, Levy DL (1989) Doppler analysis of the umbilical artery: the importance of choosing the placental end of the cord. J Ultrasound Med 8:219–221

    PubMed  CAS  Google Scholar 

  15. Mehalek KE, Rosenberg J, Berkowitz GS, Chitkara U, Berkowitz RL (1989) Umbilical and uterine artery flow velocity waveforms: effect of the sampling site on Doppler ratios. J Ultrasound Med 8:171–176

    PubMed  CAS  Google Scholar 

  16. Vieyres P, Durand A, Patat F et al (1991) Influence of the measurement location on the resistance index in the umbilical arteries: a hemodynamic approach. J Ultrasound Med 10:671–675

    PubMed  CAS  Google Scholar 

  17. Ruissen CJ, von Drongelen MM, Hoogland HJ, Jager W, Hoeks AP (1990) Characteristics of the umbilical artery velocity waveform as function of measurement site. Gynecol Obstet Invest 30:212–216

    Article  PubMed  CAS  Google Scholar 

  18. FitzGerald DE, Stuart B, Drumm JE, Duignan NM (1984) The assessment of fetoplacental circulation with continuous wave Doppler ultrasound. Ultrasound Med Biol 10:371–376

    Article  PubMed  CAS  Google Scholar 

  19. Hastie SJ, Howie CA, Whittle MJ, Rubin PC (1988) Daily variability of umbilical and lateral uterine wall artery blood velocity waveform measurements. Br J Obstet Gynaecol 95:571–574

    PubMed  CAS  Google Scholar 

  20. Stuart B, Drumm JE, FitzGerald DE, Duignan NM (1980) Fetal blood flow velocity waveforms in normal pregnancy. Br J Obstet Gynaecol 87:780–786

    PubMed  CAS  Google Scholar 

  21. Arduini D, Rizzo G (1991) Umbilical artery velocity waveforms in early pregnancy: a transvaginal color Doppler study. J Clin Ultrasound 19:335–339

    PubMed  CAS  Google Scholar 

  22. Wladimiroff JW, Huisman TW, Stewart PA (1991) Fetal and umbilical flow velocity waveforms between 10–16 weeks’ gestation: a preliminary study. Obstet Gynecol 78:812–814

    PubMed  CAS  Google Scholar 

  23. Reuwer PJHM, Bruinse HW, Stoutenbeek P, Haspels AA (1984) Doppler assessment of the fetoplacental circulation in normal and growth retarded fetuses. Eur J Obstet Gynecol Reprod Biol 18:199–205

    PubMed  CAS  Google Scholar 

  24. Dawes GS (1968) Fetal and neonatal physiology. Year Book, Chicago

    Google Scholar 

  25. Anderson DF, Faber JJ (1984) Regulation of the fetoplacental blood flow in the lamb. Am J Physiol 247:R567–R574

    PubMed  CAS  Google Scholar 

  26. Kaufmann P, Luckhardt M, Leiser R (1984) Three dimensional representation of the fetal vessel system in the human placenta. Trophoblast Res 3:113–138

    Google Scholar 

  27. Thompson RS, Trudinger BJ, Cook CM (1985) Doppler ultrasound waveforms in the fetal umbilical artery: quantitative analysis technique. Ultrasound Med Biol 11:707–714

    Article  PubMed  CAS  Google Scholar 

  28. Mires G, Dempster J, Patel NB et al (1987) The effect of fetal heart rate on umbilical artery flow velocity waveform. Br J Obstet Gynaecol 94:665–669

    PubMed  CAS  Google Scholar 

  29. Yarlagadda P, Willoughby L, Maulik D (1989) Effect of fetal heart rate on umbilical arterial Doppler indices. J Ultrasound Med 8:215–218

    PubMed  CAS  Google Scholar 

  30. Maulik D, Downing GJ, Yarlagadda P (1990) Umbilical arterial Doppler indices in acute uteroplacental flow occlusion. Echocardiography 7:619–627

    Google Scholar 

  31. Downing GJ, Yarlagadda P, Maulik D (1991) Effects of acute hypoxemia on umbilical arterial Doppler indices in a fetal ovine model. Early Hum Dev 25:1–10

    Article  PubMed  CAS  Google Scholar 

  32. Downing GJ, Maulik D, Phillips C, Kadado T (1993) In vivo correlation of Doppler waveform analysis with arterial input impedance parameters. J Ultrasound Med Biol 19:549–559

    Article  CAS  Google Scholar 

  33. Mansouri H, Gagnon R, Hunse C (1989) Relationship between fetal heart rate and umbilical blood flow velocity in term human fetuses during labor. Am J Obstet Gynecol 160:1007–1012

    PubMed  CAS  Google Scholar 

  34. Ruble W, Gnirs J, Schmidt W (1993) Fetal heart rate and Doppler flow parameters in fetal blood vessels — evaluation of 2517 individual signals. Z Geburtshilfe Perinatol 197:90–94

    Google Scholar 

  35. Mulders LG, Muijers GJ, Jongsma HW, Nijhuis JG, Hemn PR (1986) The umbilical artery blood flow velocity waveform in relation to fetal breathing movements, fetal heart rate and fetal behavioural states in normal pregnancy at 37 to 39 weeks. Early Hum Dev 14:283–293

    Article  PubMed  CAS  Google Scholar 

  36. Dawes GS, Fox HE, Leduc BM, Liggins GC, Richards RT (1972) Respiratory movements and rapid eye movement sleep in the fetal lamb. J Physiol (Lond) 220:119–143

    CAS  Google Scholar 

  37. Chiba Y, Utsu M, Kanzaki T, Hasegawa T (1985) Changes in venous flow and intratracheal flow in fetal breathing movements. Ultrasound Med Biol 11:43–49

    Article  PubMed  CAS  Google Scholar 

  38. Koppelaar I, Wladimiroff JW (1992) Quantitation of breathing-related modulation of umbilical arterial and venous flow velocity waveforms in the normal term fetus. Eur J Obstet Gynecol Reprod 45:177–180

    CAS  Google Scholar 

  39. Spencer JA, Price J, Lee A (1991) Influence of fetal breathing and movements on variability of umbilical Doppler indices using different numbers of waveforms. J Ultrasound Med 10:37–41

    PubMed  CAS  Google Scholar 

  40. Hoskins PR, McDicken WN, Johnstone FD et al (1988) Determination of the presence of fetal apnoea using umbilical artery and umbilical vein Doppler waveforms. Ultrasound Med Biol 14:589–592

    Article  PubMed  CAS  Google Scholar 

  41. Prechtl HFR, Beintema DJ (1964) The neurological examination of the full term newborn infant. Clinics in Developmental Medicine No 12. Heinmann Medical Books Ltd, London

    Google Scholar 

  42. Nijhuis JG, Prechtl HFR, Martin CB Jr, Bots RSGM (1982) Are there behavioral states in the human fetus? Early Hum Dev 6:177–195

    Article  PubMed  CAS  Google Scholar 

  43. Van Eyck J, Wladimiroff JW, van der Wijngaard JA, Noordam MJ, Prechtl HFR (1987) The blood flow velocity waveform in the fetal internal carotid and umbilical artery; its relationship to fetal behavioral states in normal pregnancy at 37–38 weeks of gestation. Br J Obstet Gynaecol 94:736–741

    PubMed  Google Scholar 

  44. Buchan PC (1982) Pre-eclampsia — a hyperviscosity syndrome. Am J Obstet Gynecol 142:111–115

    PubMed  CAS  Google Scholar 

  45. Giles WB, Trudinger BJ (1986) Umbilical cord whole blood viscosity and the umbilical artery flow velocity time waveforms: a correlation. Br J Obstet Gynaecol 93:466–470

    PubMed  CAS  Google Scholar 

  46. Steel SA, Pearce JM, Nash G et al (1989) Correlation between Doppler flow velocity waveforms and cord blood viscosity. Br J Obstet Gynaecol 96:1168–1172

    PubMed  CAS  Google Scholar 

  47. Kinsella SM, Lee A, Spencer JA (1990) Maternal and fetal effects of the supine and pelvic tilt positions in late pregnancy. Eur J Obstet Gynecol Reprod Biol 36:11–17

    Article  PubMed  CAS  Google Scholar 

  48. Sorensen TK, Hendricks S, Easterling TR, Carlson KL, Benedetti TJ (1992) Effect of orthostatic stress on umbilical Doppler waveforms in normal and hypertensive pregnancies. Am J Obstet Gynecol 167:643–647

    PubMed  CAS  Google Scholar 

  49. Drack G, Kirkinen P, Baumann H, Muller R, Huch R (1988) Doppler ultrasound studies before and following short-term maternal stress in late pregnancy. Z Geburtshilfe Perinatol 192:173–177

    PubMed  CAS  Google Scholar 

  50. Veille JC, Bacevice AE, Wilson B, Janos J, Hellerstein HK (1989) Umbilical artery waveform during bicycle exercise in normal pregnancy. Obstet Gynecol 73:957–960

    PubMed  CAS  Google Scholar 

  51. Erkkola RU, Pirhonen JP, Kivijarvi AK (1992) Flow velocity waveforms in uterine and umbilical arteries during submaximal bicycle exercise in normal pregnancy. Obstet Gynecol 79:611–615

    PubMed  CAS  Google Scholar 

  52. Maulik D (1989) Basic principles of Doppler ultrasound as applied in obstetrics. Clin Obstet Gynecol 32:628

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Maulik, D. (2005). Umbilical Doppler Velocimetry: Normative Data and Diagnostic Efficacy. In: Maulik, D. (eds) Doppler Ultrasound in Obstetrics and Gynecology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28903-8_10

Download citation

  • DOI: https://doi.org/10.1007/3-540-28903-8_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-23088-5

  • Online ISBN: 978-3-540-28903-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics