Doppler Ultrasound Evaluation of the Fetus and Placenta

Introduction

Doppler ultrasound (US) can be used to assess waveform patterns of blood flow in various vascular beds in the maternal, fetal, and placental circulation. The information gained from the analysis of waveforms in combination with clinical factors provides insight into maternal adaptation to pregnancy, placental resistance, and fetal cardiovascular status, and thus can guide pregnancy management in many conditions. Doppler evaluation can be roughly divided into arterial, venous, or cardiac Doppler. Doppler evaluation of the uterine artery, umbilical artery (UA), middle cerebral artery (MCA), descending aorta, ductus venosus (DV), inferior vena cava, umbilical vein, and the hepatic veins provides valuable information on placental and fetal circulations in pregnancy. However, in clinical practice placental (uterine and UA Doppler), MCA, and DV Doppler are the most frequently used. Cardiac Doppler, which is used primarily for evaluation of diastolic function, global myocardial performance, and cardiac ejection force or systolic performance, is reviewed in Chapter 74, Chapter 75, Chapter 76, Chapter 77, Chapter 78, Chapter 79, Chapter 80, Chapter 81, Chapter 82, Chapter 83, Chapter 84, Chapter 85, Chapter 86, Chapter 87, Chapter 88, Chapter 89, Chapter 90, Chapter 91, Chapter 92, Chapter 93, Chapter 94 . This chapter will discuss technique and applications for the vessels most commonly examined in pregnancy: uterine, umbilical, and middle cerebral arteries, as well as the DV.

Fundamentals of Doppler Imaging