The Importance of Venous Doppler Velocimetry for Evaluation of Intrauterine Growth Restriction

Abstract

The management of growth-restricted fetuses requires accurate diagnosis to optimize the timing of delivery. Doppler velocimetry is the only noninvasive method for assessing the fetoplacental hemodynamic status. This review will give a critical overview of the current knowledge on fetal venous blood flow in pregnancies complicated by in-trauterine growth-restricted fetuses. Adaptation of the circulation in intrauterine growth-restricted fetuses is described. Normal and abnormal venous Doppler waveforms are presented. Correlations of abnormal waveforms with the presence of acidemia and perinatal outcomes are emphasized. Limitations of venous Doppler velocimetry for optimizing the time for delivery and the perinatal outcome are also presented.

Reproducibility and variability in the assessment of color-coded tissue velocity imaging of the fetal myocardium¬

“…For example, fetal oxygen deprivation is most likely indicated by a prolongation of the isovolumetric phases [15,16] . This is in accordance with reported changes of the modified myocardial performance index (Mod-MPI) in the IUGR fetus [17] , an index that reflects the relationship between the isovolumetric and ejection time intervals.…”

Clinical Correlation of Doppler Velocimetry and Intrauterine Growth Restriction (Iugr)

“…Studies on venous Doppler velocimetry are being conducted nowadays. [3] However, venous Doppler velocimetry has its own limitations. [3] The cerebroplacental ratio, which measures the proportion of flow supplying the brain and placenta is a good parameter for the assessment of IUGR and hypoxia.…”

“…[2] Doppler velocimetry is the only non-invasive method for assessing the foetoplacental haemodynamic status. [3] It enables one to know the umbilical arterial flow/venous flow, the resistance of placenta with the help of Resistive Index (RI) and the velocity/volume of flow in umbilical arteries/veins and other different foetal vessels. Abnormalities of the foetoplacental circulation are forerunners of IUGR.…”

A clinical study of role of colour Doppler imaging in pregnancies at risk.

“…The combination of longitudinal multivessel monitoring and biophysical profile score together with the gestational age could help in optimising management of fetus with IUGR. 5 Doppler investigation of the fetal venous circulation may play an important role in monitoring growth retarded fetus and optimising time of delivery. 6 Cerebral/umbilical ratio found to be the best parameter to diagnose small for gestational age fetus and also adverse perinatal outcome.…”