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      A Radiologist's Guide to the Performance and Interpretation of Obstetric Doppler US.

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          Abstract

          Doppler US provides a unique window to the fetoplacental circulation, allowing assessment of fetal well-being. Doppler US of the umbilical artery is an integral component of managing the fetus with growth restriction; and Doppler US of the middle cerebral artery, as a noninvasive means of detecting fetal anemia, has revolutionized the management of pregnancies complicated by alloimmunization. Serial use of amniocentesis, with its attendant risks, has been replaced by serial Doppler US examinations. Invasive procedures are now reserved for the treatment of anemia with intrauterine transfusion. Technique is critical to obtain the best waveforms for ease of shape assessment, velocity measurement, and calculation of various ratios. In this article, the safety of Doppler US is reviewed, the fetal circulation is described, and the role of Doppler US is demonstrated in first-trimester screening and in the evaluation of growth restriction, anemia, and other causes of fetal compromise in the second and third trimesters. Sampling technique is explained, and normal and abnormal waveforms are illustrated for the ductus venosus, umbilical artery, umbilical vein, middle cerebral artery, and uterine artery. Some examples of clinical cases are provided to illustrate how the results are used in clinical practice. Clinical examples of velamentous insertion and vasa previa are also provided to aid the practicing radiologist with recognition of these entities. In particular, vasa previa is considered a critical finding; it alters pregnancy management, requiring hospital admission, administration of steroid therapy, and planned early cesarean delivery. ©RSNA, 2019.

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          Author and article information

          Journal
          Radiographics
          Radiographics : a review publication of the Radiological Society of North America, Inc
          Radiological Society of North America (RSNA)
          1527-1323
          0271-5333
          May 7 2019
          : 39
          : 3
          Affiliations
          [1 ] From the Department of Radiology and Imaging Sciences, University of Utah Health, 30N 1099E, Room 1A71, Salt Lake City, UT 84132.
          Article
          10.1148/rg.2019180152
          31059392
          58c91350-1334-4b36-9145-7b3833ef91d4
          History

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