European Journal of Obstetrics & Gynecology and Reproductive Biology
Fetal arterial Doppler-IUGR and hypoxia
Section snippets
Peripheral fetal flow assessment
In order to quantify the vascular resistances, various indices which measure the proportion of systolic flow within the total forward flow (M) during one cardiac cycle, or the relative amplitude of systolic (S) to diastolic (D) flow, have been proposed. Most of these parameters change with the resistance to flow into the vascular territory investigated (PI=S−D/M,RI=S−D/S,R=S/D,R=D/S). Increased vascular resistance may be due to vascular disease (placental infarction or fibrosis) or to distal
Umbilical circulation
The umbilical vascular resistance indices, when greater than the upper limit of the normal range (>2xS.D.) are frequently associated with IUGR. The sensitivity of this method in this application is generally about 65 to 70%. Several authors have shown that when used as a predictor of fetal well-being, only strong disturbances of the umbilical arterial flow such as absent end diastolic flow, are frequently associated with acute fetal patency, but in this case it is still difficult to evaluate
Recommendations and perspectives
Fetal Doppler indices were initially developed for the detection of IUGR and fetal hypoxia, and used in case of suspicion of severe fetal growth retardation and poor fetal outcome. Subsequently combinations of Doppler cerebral and umbilical or aortic indices were used to make the method more sensitive. Thus many obstetricians integrated these Doppler indices into the management process of the pregnancy.
Nevertheless, because the resistance indices are heart rate-dependent, it is dangerous to
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