Conclusion
It has been demonstrated, without doubt, that the clinical use of umbilical artery flow velocity waveforms reduces perinatal deaths and unnecessary admission to hospital or induction of labor for suspected placental insufficiency. It can also be used in primary health care settings to differentiate between a normal fetus with poor growth and placental insufficiency.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Aardema MW, De Wolf BTHM, Saro MCS, Oosterhof H, Fidler V, Aarnoudse JG (2000) Quantification of the diastolic notch in Doppler ultrasound screening of uterine arteries. Ultrasound Obstet Gynecol 16:630–643
ACOG practice bulletin (2001) Intrauterine growth restriction. In J Gynecol Obstet 72:85–96
Adamson SL (1999) Arterial pressure, vascular input impedance, and resistance as determinants of pulsatile blood flow in the umbilical artery. Eur J Obstet Gynecol Reprod Biol 84:119–125
Albaiges G, Missfelder-Lobos H, Lees C, Parra M, Nicolaides KH (2000) One-stage screening for pregnancy complications by colour Doppler assessment of the uterine arteries at 23 weeks’ gestation. Obstet Gynecol 96:559–564
Alfirevic Z, Neilson JP (1995) Doppler ultrasonography in high-risk pregnancies: systemic review with meta-analysis. Am J Obstet Gynecol 172:1379–1387
Antsaklis A, Daskalakis G, Tzortzis E, Michalas S (2000) The effect of gestational age and placental location on the prediction of pre-eclampsia by uterine artery Doppler velocimetry in low-risk nulliparous women. Ultrasound Obstet Gynecol 16:635–639
Aquilina J, Barnett A, Thompson O, Harrington K (2000) Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of pre-eclampsia. Ultrasound Obstet Gynecol 16:163–170
Arbeille P (1997) Fetal arterial Doppler-IUGR and hypoxia. Eur J Obstet Gynecol Reprod Biol 75:51–53
Bar J, Hod M, Pardo J, Fisch B, Rabinerson D, Kaplan B, Meizner I (1997) Effect on fetal circulation of low-dose aspirin for prevention and treatment of preeclampsia and intrauterine growth restriction: Doppler flow study. Ultrasound Obstet Gynecol 9:262–265
Bernstein PS, Minior VK, Divon MY (1997) Neonatal nucleated red blood cell counts in small-for-gestational age fetuses with abnormal umbilical artery Doppler studies. Am J Obstet Gynecol 177:1079–1084
Brar HS, Medearis AL, DeVore GR, Platt LD (1988) Maternal and fetal blood flow velocity waveforms in patients with preterm labor: effect of tocolytics. Obstet Gynecol 72:209–214
Browns IA, Robertson WB, Dixon HG (1972) The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Ann 1:177
Brezinka C (2001) Fetal hemodynamics. J Perinat Med 29:371–380
Bricker L, Nielson JP (2003) Routine Doppler ultrasound in pregnancy (Cochrane review). In: The Cochrane Library, issue 2. Update software, Oxford
Bush KD, O’Brien JM, Barton JR (2001) The utility of umbilical artery Doppler investigation in women with the HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome. Am J Obstet Gynecol 184: 1087–1089
Campbell S, Diaz-Recasens J, Griffin DR, Cohen-Overbeek TE, Pearce JM, Wilson K, Teague M (1982) New Doppler technique for assessing uteroplacental blood flow. Lancet 8326:675–677
Caritis S, Sibai B, Hauth J, Lindheimer MD, Klebanoff M, Thom E, Van Dorsten P, Landon M, Paul R, Miodovnik M, Meis P, Thurnau G, and the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units (1998) Low-dose aspirin to prevent preeclampsia in women at high risk. N Engl J Med 338:701–705
Caritis S, Sibai B, Hauth J, Lindheimer MD, Van Dorsten P, Klebanoff M, Thom E, Landon M, Paul R, Miodovnik M, Meis P, Thurnau G, Dombrowski M, McNellis D, and the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units (1998) Predictors of pre-eclampsia om women at high risk. Am J Obstet Gynecol 179:946–951
Chien PFW, Arnott N, Gordon A, Owen P, Khan KS (2000) How useful is uterine artery Doppler flow velocimetry in the prediction of pre-eclampsia, intrauterine growth retardation and perinatal death? An overview. Br J Obstet Gynaecol 107:196–208
CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group (1994) CLASP: a randomized trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. Lancet 343: 619–629
Coleman MAG, McCowan LME, North RA (2000) Midtrimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high-risk women. Ultrasound Obstet Gynecol 15:7–12
Coomarasamy A, Papaioannou S, Gee H, Khan KS (2001) Aspirin for the prevention of preeclampsia in women with abnormal uterine artery Doppler: a meta-analysis. Obstet Gynecol 98:861–866
Degani S, Lewinsky RM, Berger H, Spiegel D (1995) Sonographic estimation of umbilical coiling index and correlation with Doppler flow characteristics. Obstet Gynecol 86:990–993
Detti F, Akiyama M, Mari G (2002) Doppler blood flow in obstetrics. Curr Opin Obstet Gynecol 14: 587–593
Divon MY (1996) Umbilical artery Doppler velocimetry: clinical utility in high-risk pregnancies. Am J Obstet Gynecol 174:10–14
Divon MY, Ferber A (2001) Umbilical artery Doppler velocimetry: an update. Semin Perinatol 25:44–47
Divon MY, Ferber A (2002) Doppler evaluation of the fetus. Clin Obstet Gynecol 45:1015–1025
Doppler French Study Group (1997) A randomized controlled trial of Doppler ultrasound velocimetry of the umbilical artery in low risk pregnancies. Br J Obstet Gynaecol 104:419–424
Du Plessis JM, Hall DR, Norman K, Odendaal HJ (2001) Reversed end-diastolic flow velocity in viable fetuses: Is there time to wait for the effect of corticosteroids before delivery? Int J Gynecol Obstet 72: 187–188
Erdem A, Erdem M, Himmetoglu O, Yildirim G, Arslan M (2003) Maternal and fetal plasma endothelia levels in intrauterine growth restriction: relation to umbilical artery Doppler flow velocimetry. J Perinat Med 31: 52–59
Fairlie FM, Lang GD, Sheldon CD (1989) Umbilical artery flow velocity waveforms in labour. Br J Obstet Gynaecol 96:151–157
Farrell T, Chien PFW, Gordon A (1999) Intrapartum umbilical artery Doppler velocimetry as a predictor of adverse perinatal outcome: a systematic review. Br J Obstet Gynaecol 106:783–792
Farrell T, Dawson T (2001) Can uterine artery Doppler velocimetry predict adverse pregnancy outcome in women with antiphospholipid syndrome? Acta Obstet Gynecol Scand 80:609–610
Fitzgerald DE, Drumm JE (1977) Non-invasive measurement of the fetal circulation using ultrasound: a new method. Br Med J 2:1450
Galan HL, Rigano S, Chyu J, Beaty B, Bozzo M, Hobbins JC, Ferrazzi E (2000) Comparison of low-and high-altitude Doppler velocimetry in the peripheral and central circulation of normal fetuses. Am J Obstet Gynecol 183:1158–1161
Giles WB (1999) Vascular Doppler techniques. Obstet Gynecol Clin North Am 26:595–606
Goffinet F, Paris-Llado J, Nisand I, Breart G (1997) Umbilical artery Doppler velocimetry in unselected and low risk pregnancies: a review of randomized controlled trials. Br J Obstet Gynaecol 104:425–430
Goffinet F, Aboulker D, Paris-Llado J, Bucourt M, Uzan M, Papiernik E, Breart G (2001) Screening with a uterine Doppler in low risk pregnant women followed by low dose aspirin in women with abnormal results: a multicenter randomized controlled trial. Br J Obstet Gynaecol 108:510–518
Grab D, Paulus WE, Erdmann M, Terinde R, Oberhoffer R, Lang D, Muche R, Kreienberg R (2000) Effects of low-dose aspirin on uterine and fetal blood flow during pregnancy: results of a randomized, placebo-controlled, double-blind trial. Ultrasound Obstet Gynecol 15:19–27
Gudmundsson S, Dubiel M (2001) Doppler velocimetry in the evaluation of fetal hypoxia. J Perinat Med 29:399–407
Hall DR, Odendaal HJ, Steyn DW, Grové D (2000) Expectant management of early onset, severe pre-eclampsia: maternal outcome. Br J Obstet Gynaecol 107:1252–1257
Hall DR, Odendaal HJ, Kirsten GF, Smith J, Grové D (2000) Expectant management of early onset severe pre-eclampsia: perinatal outcome. Br J Obstet Gynaecol 107:1258–1264
Hall DR, Odendaal HJ, Steyn DW (2001) Delivery of patients with early onset, severe pre-eclampsia. Int J Gynecol Obstet 74:143–150
Hall DR, Odendaal HJ, Steyn DW (2001) Expectant management of severe pre-eclampsia in the mid-trimester. Eur J Obstet Gynecol Reprod Biol 96:168–172
Harrington K, Kurdis W, Aquilina J, England P, Campbell S (2000) A prospective management study of slow-release aspirin in the palliation of uteroplacental insufficiency predicted by uterine artery Doppler at 20 weeks. Ultrasound Obstet Gynecol 15:13–18
Jackson MR, Walsh AJ, Morrow RJ, Mullen JBM, Lye SJ, Ritchie JWK (1995) Reduced placental villous tree elaboration in small-for-gestational-age pregnancies: relationship with umbilical artery Doppler waveforms. Am J Obstet Gynecol 172:518–525
Joern H, Funk A, Rath W (1999) Doppler sonographic findings for hypertension in pregnancy and HELLP syndrome. J Perinat Med 27:388–394
Karsdorp VHM, Van Vugt JMG, Van Geijn HP, Kostense PJ, Arduini D, Montenegro N, Todros T (1998) Clinical significance of absent or reversed end-diastolic velocity waveforms in umbilical artery. Lancet 344:1664–1667
Karsdorp VHM (1998) Abnormal Doppler velocities in the umbilical artery. Eur J Obstet Gynecol Reprod Biol 80:129–131
Kingdom JCP, Burrell SJ, Kaufmann P (1997) Pathology and clinical implications of abnormal umbilical artery Doppler waveforms. Ultrasound Obstet Gynecol 9:271–286
Kingdom JCP, Rodeck CH, Kaufmann P (1997) Umbilical artery Doppler: more harm than good? Br J Obstet Gynaecol 104:393–396
Kirsten GF Van Zyl N, Smith M, Odendaal HJ (1999) Necrotizing enterocolitis in infants born to women with severe early preeclampsia and absent end-diastolic umbilical artery Doppler flow velocity waveforms. Am J Perinatol 16:309–313
Kirsten GF Van Zyl JI, Van Zijl F, Maritz JS, Odendaal HJ (2000) Infants of women with severe early preeclampsia: the effect of absent end-diastolic umbilical artery Doppler flow velocities on neurodevelopmental outcome. Acta Paediatr 89:566–570
Kirsten GF Bergman NJ, Hann FM (2001) Kangaroo mother care in the nursery. Pediatr Clin North Am 48: 443–452
Knight M, Duley L, Henderson-Smart DJ, King JF (2003) Antiplatelet agents for preventing and treating pre-eclampsia (Cochrane Review). In: The Cochrane Library, issue 2. Update software, Oxford
Kofinas AD, Penry M, Greiss FC Jr, Mciss PJ, Nelson LH (1988) The effect of placental location on uterine artery flow velocity waveforms. Am J Obstet Gynecol 159:1504–1508
Korszun P, Dubiel M, Breborowicz G, Danska A and Gudmundsson S (2002) Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy. J Perinat Med 30:235–241
Lees C (2000) Opinion. Uterine artery Doppler: time to establish the ground rules. Ultrasound Obstet Gynecol 16:607–609
Ley D, Laurin J, Bjerre I, Maršál K (1996) Abnormal fetal aortic waveform and minor neurological dysfunction at 7 years of age. Ultrasound Obstet Gynecol 8: 152–159
Ley D, Tideman E, Laurin J, Bjerre I, Maršál K (1996) Abnormal fetal aortic waveform and intellectual function at 7 years of age. Ultrasound Obstet Gynecol 8: 160–165
Macara L, Kingdom JCP, Kaufmann P, Kohnen G, Hair J, More TAR, Lyall F, Greer IA (1996) Structural analysis of placental terminal villi from growth-restricted pregnancies with abnormal umbilical artery Doppler waveforms. Placenta 17:37–48
Manning FA, Morrison I, Lange IR, Harman C (1982) Antepartum determination of fetal health: composite biophysical profile scanning. Clin Perinatol 9:285–296
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
Maršál K (2002) Intrauterine growth restriction. Curr Opin Obstet Gynecol 14:127–135
Maulik D, Figueroa R, Sicuranza G, Garry D (1998) Guideline/reference values. J Fertil Reprod Spec Edit 2:5–10
McCowan LME, North RA, Harding JE (2001) Abnormal uterine artery Doppler in small-for-gestational-age pregnancies is associated with later hypertension. AustZ J Obstet Gynaecol 41:56–60
Mires G, Dempster J, Patel NB, Crawford JW (1987) The effect of fetal heart on umbilical artery flow velocity waveforms. Br J Obstet Gynaecol 94:665–669
Nakatsuka M, Takata M, Tada K, Asagiri K, Habara T, Noguchi S, Kudo T (2002) A long-term transdermal nitric oxide donor improves uteroplacental circulation in women with preeclampsia. J Ultrasound Med 21:831–836
Nicolaides KH, Bilardo CM, Soothill PW, Campbell S (1988) Absence of end-diastolic frequencies in umbilical artery: a sign of fetal hypoxia and acidosis. Br Med J 297:1026–1027
Neilson JP, Alfirevic Z (2003) Doppler ultrasound for fetal assessment in high-risk pregnancies (Cochrane Review). In: The Cochrane Library, issue 3. Update software, Oxford
Nienhuis SJ, Vles JSH, Gerver WJM, Hoogland HJ (1997) Doppler ultrasonography in suspected intrauterine growth retardation: a randomized clinical trial. Ultrasound Obstet Gynecol 9:6–13
Odendaal HJ, Pattinson RC, Du Toit R (1987) Fetal and neonatal outcome in patients with severe pre-eclampsia before 34 weeks. S Afr Med J 71:555–558
Odendaal HJ, Pattinson RC, Du Toit R, Grove D (1988) Frequent fetal heart rate monitoring for early detection of abruptio placentae in severe proteinuric hypertension. S Afr Med J 74:19–21
Odendaal HJ, Steyn DW, Norman K, Kirsten GF Smith J, Theron GB (1995) Improved perinatal mortality rates in 1001 patients with severe pre-eclampsia. S Afr Med J 85:1071–1076
Odendaal HJ, Hall DR, Grove D (2000) Risk factors for and perinatal mortality of abruptio placentae in patients hospitalised for early onset severe pre-eclampsia: a case controlled study. J Obstet Gynaecol 20:358–364
Oettle CA, Odendaal HJ (2000) Umbilical artery blood gases in newborns of high-risk mothers delivered within 6 hours of antenatal fetal heart monitoring. S Afr Med J 90:705–706
Ohkuchi A, Minakami H, Sato I, Mori H, Nakano T, Tateno (2000) Predicting the risk of pre-eclampsia and a small-for-gestational-age infant by quantitative assessment of the diastolic notch in uterine artery flow velocity waveforms in unselected women. Ultrasound Obstet Gynecol 16:171–178
Ott WJ (1997) Sonographic diagnosis of intrauterine growth restriction. Clan Obstet Gynecol 40: 787–795
Owen P, Harrold AJ, Farrell T (1997) Fetal size and growth velocity in the prediction of intrapartum Caesarean section for fetal distress. Br J Obstet Gynecol 104:445–449
Ozeren M, Dinc H, Ekmen U, Senekayli C, Aydemir V (1999) Umbilical and middle cerebral artery Doppler indices in patients with preeclampsia. Eur J Obstet Gynecol Reprod Biol 82:11–16
Park YW, Cho JS, Choi HM, Kim TY, Lee SH, Yu JK, Kim JW (2000) Clinical significance of early diastolic notch depth: uterine artery Doppler velocimetry in the third trimester. Am J Obstet Gynecol 182:1204–1209
Pattinson RC, Theron GB, Thompson ML, Lai Tung M (1989) Doppler ultrasonography of the fetoplacental circulation: normal references values. S Afr Med J 76:623–625
Pattinson RC, Norman K, Odendaal HJ (1993) The use of Doppler velocimetry of the umbilical artery before 24 weeks’ gestation to screen for high-risk pregnancies. S Afr Med J 83:734–736
Reed KL (1997) Doppler: the fetal circulation. Clan Obstet Gynecol 40:750–754
Salafia CM, Pezzullo JC, Minior VK, Divon MY (1997) Placental pathology of absent and reversed end-diastolic flow in growth-restricted fetuses. Obstet Gynecol 90: 830–836
Satomura S (1959) Study of the flow patterns in peripheral arteries by ultrasonics. J Acoustical Soc Jap 15:151–158
Schuchter K, Metzenbauer M, Hafner E, Philipp K (2001) Uterine artery Doppler and placental volume in the first trimester in the prediction of pregnancy complications. Ultrasound Obstet Gynecol 19:590–592
Semchyshyn S, Zuspan FP, Cordero L (1983) Cardiovascular response and complications of glucocorticoid therapy in hypertensive pregnancies. Am J Obstet Gynecol 145:530–533
Skinner J, Greene RA, Gardeil F, Stuart B, Turner MJ (1998) Does increased resistance on umbilical artery Doppler preclude a trial of labour? Eur J Obstet Gynecol Reprod Biol 79:35–38
Soregalori M, Valcamonico A, Scalvi L, Danti L, Frusca T (2001) Late normalisation of uterine artery velocimetry in high-risk pregnancy. Eur J Obstet Gynecol Reprod Biol 95:42–45
Steyn DW, Odendaal HJ (1997) Randomized controlled trial of ketanserin and aspirin in prevention of preeclampsia. Lancet 350:1267–1271
Takata M, Nakatsuka M, Kudo T (2002) Differential blood flow in uterine, ophthalmic and brachial arteries of preeclamptic women. Obstet Gynecol 100:931–939
The GRIT Study Group (2003) A randomized trial of timed delivery for the compromised preterm fetus: short term outcomes and Bayesian interpretation. Br J Obstet Gynaecol 110:27–32
Theron GB, Theron AM, Odendaal HJ (2002) Symphysis-fundus growth measurement followed by umbilical artery Doppler velocimetry to screen for placental insufficiency. Int J Gynecol Obstet 79:263–264
Todros T, Ronco G, Fianchino O, Rosso S, Gabrielli S, Valsecchi L, Spagnolo D, Acanfora L, Biolcati M, Segnan N, Pilu G (1996) Accuracy of the umbilical arteries Doppler flow velocity waveforms in detecting adverse perinatal outcomes in a high-risk population. Acta Obstet Gynecol Scand 75:113–119
Todros T, Sciarrone A, Piccoli E, Guiot C, Kaufmann P, Kingdom J (1993) Umbilical Doppler waveforms and placental villous angiogenesis in pregnancies complicated by fetal growth restriction. Obstet Gynecol 93: 499–503
Trudinger BJ, Cook CM (1985) Umbilical and uterine artery flow velocity waveforms in pregnancy associated with major fetal abnormality. Br J Obstet Gynaecol 92:666–670
Vainio M, Kujansuu E, Iso-Mustajärvi M, Mäenpää J (2002) Low dose acetylsalicylic acid in prevention of pregnancy-induced hypertension and intrauterine growth retardation in women with bilateral uterine artery notches. Br J Obstet Gynaecol 109:161–167
Valensise H, Vasapollo B, Novella GP, Larciprete G, Romanini ME, Arduini D, Galante A, Romanini C (2001) Maternal diastolic function in asymptomatic pregnant women with bilateral notching of the uterine artery waveform at 24 weeks’ gestation: a pilot study. Ultrasound Obstet Gynecol 18:450–455
Van den Wijngaard JAGW, Van Eyck J, Wladimiroff JW (1988) The relationship between fetal heart rate and Doppler blood flow velocity waveforms. Ultrasound Med Biol 14:593–597
Venkat-Raman N, Backos M, Teoh TG, Lo WTS, Regan L (2001) Uterine artery Doppler in predicting pregnancy outcome in women with antiphospholipid syndrome. Obstet Gynecol 98:235–242
Wallace EM, Baker LS (1999) Effect of antenatal betamethasone administration on placental vascular resistance. Lancet 353:1404–1407
Westergaard HB, Langhoff-Roos J, Lingman G, Maršál K, Kreiner S (2001) A critical appraisal of the use of umbilical artery Doppler ultrasound in high-risk pregnancies: use of metanalyses in evidence-based obstetrics. Ultrasound Obstet Gynecol 17:466–476
Yarlagadda P, Willoughby L, Maulik D (1989) Effect of fetal heart rate on umbilical arterial Doppler indices. J Ultrasound Med 8:215–218
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Odendaal, H. (2005). Doppler Velocimetry and Hypertension. In: Maulik, D. (eds) Doppler Ultrasound in Obstetrics and Gynecology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28903-8_19
Download citation
DOI: https://doi.org/10.1007/3-540-28903-8_19
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-23088-5
Online ISBN: 978-3-540-28903-6
eBook Packages: MedicineMedicine (R0)