Doppler ultrasonography- special ultrasound examination of the work of the vessels of the unborn baby. The diagnostic method is based on the so-called Doppler effect, which ultrasonic waves have - when they come into contact with moving bodies, they are reflected, while changing the frequency of their oscillations. As a result of this effect, a sensor that perceives this type of waves registers a change in frequency, which is decoded by a special program and allows you to obtain an image in the form of a graph or picture.

What can you learn with Doppler?

Unlike traditional ultrasound, Doppler ultrasound is able to show the doctor color-coded images showing the direction of blood flow, its velocity, and areas that are blocked. During pregnancy, this technique allows you to informatively and accurately study the blood circulation in the placenta and the mother-fetus system as a whole. Doppler provides data that cannot be obtained with conventional ultrasound, namely:

• establishes the patency and state of the lumen of the vessels in the baby's umbilical cord;
• fetal heart condition;
• helps to find out if the blood vessels of the child are well filled with blood;
• to diagnose in the early stages the development of hypoxia or insufficient functioning of the placenta, pathology of the heart, etc.

The event is especially expedient for women with bleeding disorders. The data obtained during the study, in combination with the results of other analyzes and diagnostic measures, make it possible to draw up a pregnancy management scheme and a birth plan.

Study types

1. Ultrasonography can be carried out in two modes. Duplex mode allows doctors to obtain accurate information regarding the state of the vessel in question, its patency, and if there is a problem, data on the cause of the obstruction of the vascular element.
2. Triplex study provides similar data, but also complements it with a color image showing the movement of blood. This details the situation and is the most informative approach to ultrasound examination of the vascular system of the fetus.

How doppler ultrasound is performed

The procedure does not differ from a conventional ultrasound and in most cases even the same machines are used. The need to go to an appointment for a Doppler study not to your usual ultrasound office, but to some other clinic may be due to the fact that the device in your hospital is not so modern and does not have an additional function that allows you to perform Doppler ultrasound. No special preparations are required, filling the stomach and bladder does not affect the results.

Once in the office, no new actions are required. It will be enough to lie on the couch, bare your tummy and relax. The doctor will apply a special gel to the skin and simply move the roller.

The procedure does not bring any discomfort or discomfort, the vaginal probe is not used in the process. The specialist will first conduct a conventional ultrasound scan, within which he will be able to assess the general condition of the uterus and the baby, and after that he will determine the place of the vessel that he wants to examine in more detail. At this stage, the Doppler function is turned on, and a picture showing blood flow appears on the screen. The entire study, especially in the absence of problems, takes very little time - about a third of an hour. During the procedure, the arteries of the uterus and umbilical cord, the middle cerebral artery of the fetus and its developing aorta are usually examined.

Indications for appointment

Visualization of blood flow is possible from the 6th week of fetal development, however, it will be most informative at a later date. Usually, Doppler ultrasound is performed at the following times:

• the first time they are sent for research at about the 20th week (within the 6th month). It is carried out in order to search for possible problems for their timely elimination, especially the event is necessary for patients who have an increased risk of developing preeclampsia, intrauterine growth retardation and fetal hypoxia;
• the next study can be scheduled at the 8th month of pregnancy, and at this stage it is necessary for a general assessment of the child's condition and planning for the upcoming birth.

If the doctor suspected any deviations from the norm, then an additional study may be prescribed. Indications for unscheduled Doppler ultrasonography are:

• high blood pressure;
• smoking;
• kidney problems;
• Rh conflict (the mother has a negative Rh factor, and the baby has a positive one);
• the presence of pathologies in past pregnancies;
• discrepancy between the date and the current size of the fetus;
• suspicion of developmental abnormalities;
• when the fact of the baby's heart rate is out of the norm;
• unsatisfactory test results;
• complex chronic diseases of the mother (for example, diabetes mellitus);
• with premature contractions.

How often can you do it?

Doppler examination is a mandatory measure in the management of pregnancy, therefore, every expectant mother undergoes the examination at least twice as planned. Given the safety of the event, if there is evidence, it is carried out as many times as necessary to control the baby's condition, and only a doctor can establish such a number. Undoubtedly, you should not visit an ultrasound scan without the need.

Is research safe for my baby?

Every mother is concerned about the health of her unborn child, and it is quite understandable why questions arise regarding the safety of research conducted during pregnancy. We can confidently say that Doppler ultrasonography is an absolutely safe method. It is highly informative and can be used even at the earliest possible date, and therefore it is indispensable in the system of prenatal diagnostics. If it happened that during the study hypoxia was detected, then timely treatment will help to avoid a worse outcome, and sometimes only with the help of Doppler it is possible to consider the entanglement of the umbilical cord. From this point of view, the diagnostic method is not only not harmful, but even very useful for the unborn child.

Decoding a Doppler study

Only a doctor can decipher the results of Doppler ultrasonography, since he has sufficient knowledge and experience for this. It is not worth trying to determine the situation on your own according to the results of the research, since most likely it will turn out to be simply meaningless. The expectant mother, of course, can familiarize herself with the data regarding the rate of indicators at different periods, but it is better to consult your doctor for a clear explanation. For informational purposes only, we propose to consider some indicators of Doppler sonography and their nomes (data are given in the table).

During pregnancy, it is prescribed after maturation of the placenta to assess blood flow. It is carried out to diagnose problems in the vascular system of the expectant mother and child. Special preparation for the examination is usually not required.

Doppler ultrasound during pregnancy is a study of the vessels of a woman and an unborn child using a special sensor - Doppler. Unlike other methods for diagnosing vascular pathologies, doppler imaging allows you to assess the performance of the middle cerebral artery and aorta of the fetus.

Ultrasound plus Doppler can detect even minor violations in the vessels, assess the speed and quality of blood flow, and the classical examination determines only the peculiarities of the baby's development and its position inside the uterus.

Doppler types

Doppler the study during pregnancy is carried out in two scanning modes: duplex and triplex. The first type is basic, and the second is additional.

Together, both scanning methods create a complete picture of the quality of blood flow in the placenta, helping doctors understand how the fetus is supplied with food, whether there are any violations of this process, infringement or compression of blood vessels. The delay in blood flow is dangerous, as it can cause oxygen starvation of the embryo, which will lead to disturbances in its development.

Additionally, Doppler ultrasound allows you to consider the circulatory system of the fetus, how it develops according to the gestational age, whether pathologies or abnormalities are present.

Triplex study

The most complete and vivid color picture helps to obtain triplex scanning. Red and blue lines in the image represent the highest or lowest blood flow velocity.

When testing arteries and veins using triplex scanning, a high-precision image is broadcast on the monitor screen, which makes it possible to distinguish the movement of red blood cells.

Duplex scanning

This type of Doppler allows you to assess the state of blood vessels and the degree of patency of their walls, helps to determine the speed of blood flow and the cause that caused its violation.

Shows:

• anatomy and vascular anomalies;
• areas of squeezing;
• places of development of pathologies.

The monitor displays a black and white image of the vascular bed. The method is less accurate than triplex.

Indications for pregnancy

There are the following indications for USDG:

• planned examination of the vessels in the baby's head and the main arteries of the pregnant woman;
• exclusion or confirmation of pathologies of intrauterine development;
• abnormalities of the placenta.

The video of the channel "Rudiamed" tells in detail about the periods of the procedure during pregnancy.

By gestational age

Routine examination in pregnant women must be done twice:

• the first - at 23-24 weeks;
• the second - by 30-34.

Doppler ultrasound is done when it is required, regardless of the timing, if the doctor considers it appropriate to conduct Doppler to eliminate risks during gestation or childbirth.

Pathologies of a pregnant woman

Diagnostics is mandatory if a pregnant woman has such pathologies:

• diabetes;
• hypertension;
• lupus erythematosus;
• vasculitis;
• Hashimoto's thyroiditis;
• preeclampsia;
• kidney disease;
• the presence of a frozen pregnancy or a spontaneous miscarriage in the anamnesis;
• conflict between the Rh factor of mother and child;
• unsatisfactory CTG results after 30 weeks;
• abdominal trauma.

Pathology in the development of pregnancy or abnormalities of the placenta

The doctor may prescribe a study in such cases:

• the proximity of the umbilical cord rings to the baby's neck;
• little / high water;
• suspicion of a brain or heart defect;
• umbilical cord presentation or its inconsistency with the proper length and / or thickness;
• placental infarction;
• the size of the fetus is less than the norm;
• sheath attachment of the umbilical cord;
• premature detachment of the placenta;
• the only umbilical artery;
• hematoma or presentation of umbilical cord vessels;
• hyper / hypoplasia of the placenta.

How is it done?

Dopplerometry is performed as follows:

1. A pregnant woman lies down on the couch and exposes her belly.
2. The doctor applies a gel to ensure a snug fit of the sensor to the skin.
3. Ultrasound pulses are sent from the Doppler to the monitor, and the sonologist begins to study the great vessels.

UZDG lasts 15-30 minutes.

Preparation for research

Doing an ultrasound scan during pregnancy can be done without preparation:

• diet - any;
• filling the bladder does not matter;
• physical and emotional stress immediately before the Doppler test does not affect the test result.

Decoding the results

You can decipher the results of the Doppler test yourself by examining the resulting graph, on which you need to:

• evaluate the uniformity of blood flow;
• pay attention to the presence of grooves or changes in the shape of the vessels;
• study the peaks of the maximum systolic and end diastolic blood flow velocities.

The movement of blood flow during the cardiac cycle

Doppler rates by week of pregnancy: tables

The results of Doppler ultrasonography must be verified with the average indicators of the norm, enclosed in the tables, where:

• LMS is the systole-diastolic ratio (shows how many times the systole exceeds the diastole);
• IR - resistance index (difference in the ratio of systole and diastole to systole);
• PI - pulsation index (the difference between systole and diastole in relation to the average flow rate inside the vessel).

The rates of change in the quantitative value of LMS in accordance with the duration of pregnancy

The tables show the limits of normal indicators of possible changes.

LMS in the uterine arteries

LMS in the umbilical cord

LMS in the middle cerebral artery

LMS of the aorta of the fetus

Rates of change in the quantitative value of IR in accordance with the duration of pregnancy

IR rates in the uterine arteries

The rate of change in IR in the arteries of the umbilical cord

IR in the fetal aorta

The rates of change in the quantitative value of PI in accordance with the duration of pregnancy

PI of blood flow in the uterine arteries

PI of blood flow in the umbilical cord

PI in the fetal cerebral artery

PI in the fetal aorta

Pooled score of all indices for major vessels at 28, 32, 36 and 40 weeks of gestation

Deviations from the norm and degree of violations

Description of signs of pathologies during pregnancy:

The most common among the pathologies of fetal development is intrauterine hypoxia - insufficient nutrition of the tissues and organs of the child with oxygen.

The inability of blood vessels to increase blood flow after maturation of the placenta occurs in the following variants:

• violation of the uteroplacental blood flow;
• violation of fetal-placental blood flow (within subcritical and critical values);
• simultaneous violation of the uteroplacental and fetal-placental blood flows.

Classification of blood flow disorders according to Medvedev

The table shows deviations from the norm and possible treatment of pathologies.

Determination of fetal hypoxia

A sign of oxygen starvation of the embryo is a decrease in heart rate variability. Additionally, it is necessary to analyze the amniotic fluid. Based on these two studies, the doctor diagnoses hypoxia and can conclude about its degree.

Is Dopplerometry Dangerous for a Pregnant Woman and a Fetus?

Studies of the effects of ultrasound on a pregnant woman and fetus (over the past 50 years) have proven the safety of Doppler ultrasound. The examination does not affect the development and functioning of organs and tissues of the human body.

Photo gallery

The photo shows the device and images obtained with triplex scanning.

Triplex scanning Fetal Doppler Blood flow in the umbilical cord, 26 weeks

Video

Video of the channel “Clinic of Reproductive Medicine named after Academician V. I. Grishchenko "Implant" tells about cases of appointment of examination.

Doppler ultrasound measures how sound waves are reflected from body tissues. The information is processed by a computer, and then the decryption is displayed on the monitor in the form of a two-dimensional color image. Doppler for pregnant women allows you to determine in a timely manner how well the fetus is developing, to exclude all possible threats to the life and health of the mother and baby.

Doppler, or in other words Doppler, is called the scientist Christian Doppler. The Austrian physicist lived in the 19th century and studied the effects of ultrasonic waves. He discovered that ultrasound is reflected from moving objects at different frequencies.

Such an ultrasound scan allows you to study the blood flow, diagnose the blood flow velocity and the diameter of the vessels. Modern devices operating at sound frequencies of more than 20,000 Hz, elusive to the human ear, are used to study the state of soft tissues. This method is practically harmless for both the pregnant woman and the fetus.

Ultrasound is reflected from the vessels, so that the device then converts the information into an image that the doctor can understand.

Ultrasound, prescribed during pregnancy, is recognized to determine the placental blood flow. If there are the slightest violations or deviations from the norm in the "mother - placenta - fetus" system, they will definitely be identified.

There are two types of Doppler examinations. The duplex method allows you to examine the vessel itself, to see how correctly the blood flow passes through it. The triplex method is more advanced - it adds a color dynamic image of red blood cells to the duplex ultrasound. This method is more accurate, gives the most detailed picture of the course of pregnancy.

Indications for Doppler

Today, a routine ultrasound scan is mandatory for all expectant mothers. It is done at least twice during the entire pregnancy. Most often, the doctor prescribes such an examination at 22-24 weeks and at 32-34 weeks. If no abnormalities are found, then two procedures are enough to make sure that the fetus is developing without deviations from the norm.

If necessary, the doctor may prescribe an additional study - Doppler. The indications for him are the following diagnoses:

• multiple pregnancy;
• pyelonephritis;
• hypertension;
• Rh-conflict between mother and child;
• inconsistency of the state of development of the fetus with the timing of pregnancy;
• large fruit size;
• breech presentation;
• preeclampsia;
• chronic diseases in the mother (diabetes mellitus, thyroid dysfunction, autoimmune diseases);
• unsatisfactory results of cardiotocography;
• preeclampsia;
• the threat of placental abruption;
• the presence of pathologies in previous pregnancies.

It is necessary to understand that Doppler differs from conventional ultrasound and is prescribed only when there are prerequisites for this. Such an examination cannot establish the sex of the child, display his image on the monitor. Doppler scans the vascular system of the placenta and the baby to determine if he is getting enough oxygen, how healthy the fetus's heart is, and how the vascular system is developing.

Deciphering the results of such a study by a qualified doctor allows you to identify possible risks in time, change the pregnancy management scheme, and determine which childbirth process will be most favorable for the mother and child. Thanks to this, it is possible to prevent pathologies in the development of the fetus, to prescribe the correct treatment in time, to give recommendations to the mother, which will ease her condition during the gestation of the fetus.

Is Doppler Necessary During Pregnancy?

Unlike a conventional ultrasound, a Doppler is not required. Despite this, doctors often prescribe it to future women in labor after 30 weeks of gestation. If there are prerequisites such as hypoxia, diabetes mellitus, gestosis, high blood pressure, Doppler is prescribed at 20-24 weeks.

Additional indications for an ultrasound scan in the second trimester are multiple pregnancies, unsatisfactory analyzes, Rh-conflict.

The picture of blood circulation shown on the screen gives the doctor a complete understanding of what recommendations to prescribe to a woman. Often the results of the examination give rise to additional diagnostics, procedures and analyzes.

Doppler referral is not a reason to believe that the pregnancy is abnormal. Due to the high information content and accuracy of the results, most obstetricians-gynecologists today prefer Doppler. This procedure must be performed by a qualified technician to obtain correct results.

How is the procedure going?

The examination itself takes 15 - 20 minutes. Before him, you do not need to observe a special diet. The procedure is very similar to a conventional ultrasound. The expectant mother should be in a horizontal position, lying on the couch. A special gel is applied to the abdomen and the examination process begins.

First, the doctor examines the state of the placenta and uterus, carefully examines the placental blood flow. Then he carefully examines the individual vessels of the brain, the umbilical cord. In many respects, the objectivity of the results depends on the professionalism of a specialist.

The image on the screen shows the general picture, which is carefully studied by the specialist. The device can also independently decode the results and display it on the screen. In combination, the professionalism of an experienced doctor and Doppler results allow you to learn a lot about the baby's health and predict the process of childbirth.

Is Doppler Dangerous?

Expectant mothers are often afraid to undergo various examinations, especially ultrasound, considering them harmful to the baby.

In fact, ultrasound does not affect the development of the fetus in any way.

But this ultrasound detects hypoxia in time, or in other words, oxygen starvation in a child. It shows whether there is an umbilical cord entanglement, determining its degree - single, triple, double.

As an example, if there is an umbilical cord entanglement, the doctor will prescribe a caesarean section to save the baby's life and make the birth process easier. The diagnosis of hypoxia is also not dangerous, provided it is detected early. Ultimately, all examinations are aimed only at detecting pathologies in order to prevent them.

Today, Doppler during pregnancy is a very effective method of research and diagnosis, which is widely used not only in obstetric practice. During its existence, such an ultrasound scan revealed many pathologies, which saved lives, preserved the health of millions of babies, and made their parents happy.

Dopplerometry during pregnancy is a modern diagnostic method using ultrasound, which allows an objective and complete examination of the blood circulation of the fetus, placenta and uterus. According to the state of the circulatory system, it is possible to assess the condition of the fetus, the speed of its development - whether the baby suffers from a lack of oxygen, as well as possible pathological changes. Fetal Doppler is the only technique that can show the exact location of vascular pathology (in the uterus, umbilical cord or placenta).

Doctor's consultation based on test results or ultrasound - 500 rubles. (at the request of the patient)

Why and when to carry out Doppler measurements during pregnancy

Today, vascular disease is one of the most common problems in medical practice. Timely diagnosis makes it possible to identify such pathologies at an early stage of development, and at the same time, many factors that can cause the development of circulatory disorders.

The value of the procedure lies in its high information content, due to which the doctor is able to identify not only the already developed pathology, but also almost imperceptible preclinical symptoms of the disease. The procedure is prescribed after complete formation of the placenta - not earlier than 18 weeks, more often at 32-34 weeks as a routine check.

If there is even a slight suspicion of fetal developmental disorders, an ultrasound scan with a Doppler is performed at any time. Doppler is done in conjunction with , while for a pregnant woman, the procedure does not differ from the classical ultrasound examination.

Method essence

This method of studying the circulatory system is based on the application of the Doppler effect.

The examination uses the same ultrasound as for a conventional ultrasound examination. The difference lies in the special Doppler sensor and the interpretation of the data obtained. During the study, ultrasonic waves are recorded, reflected not from static tissues, but from moving objects - blood cells, as a result of which the frequency of the reflected rays changes greatly in comparison with the studied ones. The machine processes the received data and creates a two-dimensional color image. Thanks to this, it is possible to assess the speed and direction of blood flow, anatomy and vascular patency.

The duration of Doppler sonography is 20 - 40 minutes. It has no contraindications, no complications, no negative effects on the body. The examination is completely painless and safe.

Indications

Gynecologists recommend to undergo a Doppler examination 1-2 times during pregnancy together with ... If there are problems, the fetal Doppler needs to be done as soon as possible. Basically, dopplerometry is prescribed when the size of the fetus does not match the gestational age. Also, the procedure is carried out in the following cases:

• complications in carrying a child;
• placental insufficiency;
• the mother has chronic and severe diseases (diabetes mellitus, hypertension, anemia, systemic diseases);
• Rh-conflict between a pregnant woman and a child;
• multiple pregnancy;
• non-immune dropsy of the fetus;
• incorrect position of the fetus in the uterus;
• premature maturation of the placenta;
• entanglement of the baby's neck with the umbilical cord, suspicion of hypoxia;
• pronounced oligohydramnios / polyhydramnios;
• preeclampsia (late toxicosis, accompanied by a deterioration in the functioning of the kidneys, blood vessels and the brain - protein appears in the urine, pressure rises);
• trauma abdomen in a pregnant woman;
• chromosomal abnormalities of the infant;
• the fetus moves less than usual or the movement is not felt at all;
• unsatisfactory results of cardiotocography;
• complications in carrying a previous pregnancy (premature birth, miscarriage, etc.).

Also, an ultrasound of the fetus with a Doppler must be done in cases where the mother is not 20 years old or she is more than 35 years old.

What does fetal dopplerometry reveal?

Doppler helps to timely identify fetal hypoxia and avoid problems even before the child is in danger, or to minimize negative consequences. With its help, the doctor can find out the reasons for entanglement with the umbilical cord and see how many times and how tightly the baby's neck is entwined. Without this vital information, specialists will not be able to choose the right tactics for childbirth, which jeopardizes the health and life of the child.

Also, using the Doppler, you can see:

• the state and rhythm of the fetal heart at rest and movement;
• the condition of the heart valves of the main blood vessels, arteries and veins;
• the speed and volume of blood flow in the peripheral circulatory system;
• blood circulation in the umbilical cord and placenta;
• the state of the circulatory system, heart and kidneys of the pregnant woman.

The information obtained allows the doctor to assess:

• patency and condition of the vascular bed, the presence of deviations that block the blood flow of the fetus;
• saturation with blood and nutrients of all tissues of the child;
• patency and condition of the umbilical cord, entanglement of the baby's neck;
• the efficiency of the placenta;
• condition and work of the circulatory system of a woman during pregnancy.

Preparation and features of the ultrasound of the fetus with Doppler

The procedure does not require any preparatory measures: neither the diet, nor the fullness of the bladder and stomach affect the examination results. The only recommendation is to take a break from eating for a couple of hours before the examination.

The pregnant woman needs to take the following with her: the direction and results of past analyzes and examinations (ultrasound, CTG, ECG), the exchange card of the pregnant woman. Paper napkins and a disposable diaper or towel are not needed - everything is provided free of charge in our clinic.

Doppler technique is similar to transabdominal ultrasound. The woman lies down on the couch with her back and exposes her belly. The doctor applies a special gel to the investigated area for better passage of ultrasonic waves and then guides the transducer over it, simultaneously examining the obtained data on the monitor. The interpretation of the results is issued to the woman on the same day.

Doppler testing during pregnancy can be done in several ways:

• Ultrasonic Doppler - used to assess the direction, intensity, nature of blood flow in the vessels.
• Duplex study - differs from the previous method in greater accuracy and informational content. It is used to assess the blood flow of blood vessels and their anatomy.
• Color mapping - the state of even the smallest vessels and their patency is color coded.

Deciphering the results of fetal dopplerometry

Assessment of the state of blood supply using Doppler is formed on the basis of the following indicators:

• Systole-diastolic ratio - the ratio of the maximum and minimum blood flow velocity;
• Index resistance - the ratio of the difference between the maximum and minimum blood flow velocity to the maximum during the period of compression;
• Pulsating index - the ratio of the difference between the maximum and minimum blood flow velocity to the average velocity over a complete heart cycle.

Fetal dopplerometry: weekly rate and prognosis for deviations

In order for the interpretation of the results to pass correctly and all deviations were identified, it is necessary to compare the data obtained with the standard values, taking into account the gestational period.

Indicators of the norm of the resistance index of the uterine arteries

Standard indicators of the pulsation index of the uterine arteries

The indicators of the right and left uterine artery can be different. The main thing is that both indicators do not go beyond the normal range. If both indicators do not correspond to the norm, this indicates a violation of the uteroplacental circulation. If one indicator - on the asymmetry of the uteroplacental blood flow

It is important to note that at 18-21 weeks, deviations of indicators may be observed due to an incomplete adaptive physiological process of cytotrophoblast invasion. In this case, fetal dopplerometry should be repeated in 2-3 weeks.

Standard indicators of the systolic-diastolic ratio in the fallopian tubes

Doppler Method: Umbilical Cord Arteries

Standard values ​​of the resistance index of the umbilical cord arteries:

Standard values ​​of the pulsation index of the umbilical cord arteries:

Obtaining zero and reverse values ​​of diastolic blood flow is considered a pathology. This indicates the critical condition of the fetus, the death of which will occur in 2-3 days. In this case, a caesarean section is immediately prescribed (if the gestational period is more than 28 weeks) to save the life of the baby.

Standard values ​​of the systolic-diastolic ratio of the umbilical arteries:

Violation of blood flow in the umbilical cord entails a delay in the development of the child.

Doppler ultrasound rates: fetal middle cerebral artery

Maximum velocity in the middle cerebral artery of the fetus:

Standard values ​​of the systolic-diastolic ratio in the middle cerebral artery:

Normal Fetal Doppler Readings: Fetal Aorta

Disturbances in the circulation of the fetal aorta can be detected only after 22-24 weeks of pregnancy.

Standard value of the fetal aortic pulsation index:

Standard values ​​of the fetal aorta resistance index:

Standard values ​​of the systolic velocity of the fetal aorta:

Standard values ​​of the systolic-diastolic ratio of the fetal aorta:

Doppler rates during pregnancy: ductus venosus

The ductus venosus is not assessed using indices. An indicator of pathology is zero or negative blood flow values. Usually, similar values ​​are obtained with fetal malnutrition, congenital heart disease, non-immune dropsy.

In the case when the blood circulation in the umbilical cord is in a critical condition, but no blood flow abnormalities have been identified in the ductus venosus, it is possible to prolong gestation until the optimal time for delivery.

How will a gynecologist understand if there is fetal hypoxia?

The doctor compares the normal Doppler measurements with the obtained result.

• An increase in IR and LMS in the uterine arteries is a sign that the baby is not getting enough oxygen. This will lead to a delay in development.
• An increase in Doppler indices for the umbilical artery is a sign of feto-placental insufficiency. This is a vascular pathology, so the fetus is already suffering. It is also a sign of preeclampsia.
• If the indicators of IR and LMS in the umbilical cords with multiple pregnancies differ, this indicates that one of the babies is experiencing hypoxia (transfusion syndrome).
• Excess LMS and IR in the aorta is a symptom of a child's poor health due to prolonged pregnancy, due to diabetes mellitus in a pregnant woman, in case of a conflict over the Rh factor, etc.
• A decrease in LMS and IR with Doppler measurements in the carotid and cerebral arteries is observed in extremely serious condition of the fetus, since in this case only the main organs that support life are supplied with blood. In such a situation, artificial childbirth should be carried out immediately.