BioeffectsLOGIQ 500 Advanced Reference Manual2276614–100 Rev. 06–13Efficacy of Fetal DopplerThe following are clinical obstetrical conditions where there areexperimental data that demonstrate the efficacy of Doppler.Provided by John C. Hobbins, M.D. and Peter Burns, Ph.D.4IUGR Many studies have shown a good correlation between abnormalwaveform (or decreased blood flow) and increased perinatalmortality5, fetal hypoxia 6,7,8, and neonatal events such asnecrotizing enterocolitis (NEC), and interventricular hemorrhage(IVH).8 It must be pointed out that the Doppler studies initiallydesigned to identify altered fetal growth had a predictably lowsensitivity9 because the category of small for dates frequentlyincludes genetically small but completely normal fetuses andneonates. Thus far, all studies have shown that the rareDoppler pattern of reverse diastolic flow in the umbilical arteryhas been very highly correlated with adverse outcome10,11 andmay warrant immediate intervention. Conversely, a normalwaveform in the umbilical artery has been rarely associatedwith stillbirth in a high risk pregnancy.Cardiac Anomalies Doppler has become an integral part of fetal echocardiographicstudies. Its use has been directly derived from well- documentedpediatric and adult Doppler research. The etiology andseriousness of fetal arrhythmias is relatively easy to determinewith pulsed Doppler interrogation of ventricular diastolic fillingpatterns.12–15 Benign patterns such as premature atrialextrasystoles can be more easily diagnosed with Doppler thanwith the older approach of M-Mode echocardiography. Dopplerhas proven useful as well in the understanding andinterpretation of structural heart disease in the fetus. A closecorrelation has been found between atrioventricular valveregurgitation in the fetus with structural heart disease and theappearance of non- immune hydrops16. Improved diagnosticand prognostic ability has permitted more accurate counselingof parents whose fetuses have structural cardiac abnormalities.
