Der Stellenwert der Doppler-sonographie bei der Betreuung von Nicht-Risikoschwangerschaften am Geburtstermin

Scholler, J.; Putz, M; Sainz, Héctor; Altrichter, R.; Philipp, K

doi:10.1159/000272187

Cited by 5 publications

(3 citation statements)

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“…Consequently, the Doppler trial data are not now thought by the review authors to be sufficiently reliable to be retained within this review. Schneider 1992 Conference abstract in English language identified - unexplained difference in numbers (250 vs 329) in Doppler vs control groups suggesting allocation bias. The definitive publication after translation from German did not explain this difference and failed to outline the trial methodology Scholler 1993 This study was translated from German for us. It was a quasi-RCT of 211 women undergoing Doppler ultrasound versus no Doppler ultrasound.…”

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Utero-placental Doppler ultrasound for improving pregnancy outcome

Stampalija

Gyte

Alfirević

2010

Cochrane Database of Systematic Reviews

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Background Impaired placentation can cause some of the most important obstetrical complications such as pre-eclampsia and intrauterine growth restriction and has been linked to increased fetal morbidity and mortality. The failure to undergo physiological trophoblastic vascular changes is reflected by the high impedance to the blood flow at the level of the uterine arteries. Doppler ultrasound study of utero-placental blood vessels, using waveform indices or notching, may help to identify the ‘at-risk’ women in the first and second trimester of pregnancy, such that interventions might be used to reduce maternal and fetal morbidity and/or mortality. Objectives To assess the effects on pregnancy outcome, and obstetric practice, of routine utero-placental Doppler ultrasound in first and second trimester of pregnancy in pregnant women at high and low risk of hypertensive complications. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (June 2010) and the reference lists of identified studies. Selection criteria Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of utero-placental vessel waveforms in first and second trimester compared with no Doppler ultrasound. We have excluded studies where uterine vessels have been assessed together with fetal and umbilical vessels. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We checked data entry. Main results We found two studies involving 4993 participants. The methodological quality of the trials was good. Both studies included women at low risk for hypertensive disorders, with Doppler ultrasound of the uterine arteries performed in the second trimester of pregnancy. In both studies, pathological finding of uterine arteries was followed by low-dose aspirin administration. We identified no difference in short-term maternal and fetal clinical outcomes. We identified no randomised studies assessing the utero-placental vessels in the first trimester or in women at high risk for hypertensive disorders. Authors’ conclusions Present evidence failed to show any benefit to either the baby or the mother when utero-placental Doppler ultrasound was used in the second trimester of pregnancy in women at low risk for hypertensive disorders. Nevertheless, this evidence cannot be considered conclusive with only two studies included. There were no randomised studies in the first trimester, or in women at high risk. More research is needed to investigate whether the use of utero-placental Doppler ultrasound may improve pregnancy outcome.

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Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Utero-placental Doppler ultrasound for improving pregnancy outcome

Stampalija

Gyte

Alfirević

2010

Cochrane Database of Systematic Reviews

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“…We excluded two studies because the previous review authors had tried to contact these authors for information needed for studies to be included and had received no response (Gonsoulin 1991; Schneider 1992). We excluded one study because it had high risk of bias; we needed further information before being able to include it and it only reported one outcome relevant to the review (induction of labour) (Scholler 1993).…”

Section: Resultsmentioning

confidence: 99%

“…Further details were sought from the authors by the authors of the previous version of this review (L Bricker and JP Neilson), without success. Schneider 1992 Conference abstract in English language identified - unexplained difference in numbers (250 vs 329) in Doppler vs control groups suggesting allocation bias. The definitive publication after translation from German did not explain this difference and failed to outline the trial methodology Scholler 1993 This study was translated from German for us. It was a quasi RCT of 211 women undergoing Doppler ultrasound vs no Doppler ultrasound.…”

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Fetal and umbilical Doppler ultrasound in normal pregnancy

Alfirević¹,

Stampalija²,

Gyte³

2010

Cochrane Database of Systematic Reviews

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Background One of the main aims of routine antenatal care is to identify the ‘at risk’ fetus in order to apply clinical interventions which could result in reduced perinatal morbidity and mortality. Doppler ultrasound study of umbilical artery waveforms helps to identify the compromised fetus in ‘high-risk’ pregnancies and, therefore, deserves assessment as a screening test in ‘low-risk’ pregnancies. Objectives To assess the effects on obstetric practice and pregnancy outcome of routine fetal and umbilical Doppler ultrasound in unselected and low-risk pregnancies. Search methods We searched the Cochrane Pregnancy and Childbirth Group Trials Register (May 2010). Selection criteria Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in unselected pregnancies compared to no Doppler ultrasound. Studies where uterine vessels have been assessed together with fetal and umbilical vessels have been included. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Main results We included five trials involving 14,185 women. The methodological quality of the trials was generally unclear because of insufficient data included in the reports. Routine fetal and umbilical Doppler ultrasound examination in low-risk or unselected populations did not result in increased antenatal, obstetric and neonatal interventions, and no overall differences were detected for substantive short term clinical outcomes such as perinatal mortality. There is no available evidence to assess the effect on substantive long term outcomes such as childhood neurodevelopment and no data to assess maternal outcomes, particularly psychological effects. Authors’ conclusions Existing evidence does not provide conclusive evidence that the use of routine umbilical artery Doppler ultrasound, or combination of umbilical and uterine artery Doppler ultrasound in low-risk or unselected populations benefits either mother or baby. Future studies should be designed to address small changes in perinatal outcome, and should focus on potentially preventable deaths.

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Routine Doppler ultrasound in pregnancy

Bricker

Neilson

2000

The Cochrane Database of Systematic Reviews

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Der Stellenwert der Doppler-sonographie bei der Betreuung von Nicht-Risikoschwangerschaften am Geburtstermin

Cited by 5 publications

References 0 publications

Utero-placental Doppler ultrasound for improving pregnancy outcome

Utero-placental Doppler ultrasound for improving pregnancy outcome

Fetal and umbilical Doppler ultrasound in normal pregnancy

Routine Doppler ultrasound in pregnancy

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