Do a Doppler test for pregnant women. What is Doppler ultrasound during pregnancy?

And Doppler examination uses a similar mechanism for obtaining data: the device analyzes the nature of the ultrasonic signal reflected from tissues or particles in a liquid. The main difference is that ultrasound produces an image of dense tissue in a static position, that is, internal organs. Based on the reflected signal, one can judge the presence or absence of anomalies in the development and position of organs.

When performing Doppler ultrasound, the Doppler effect is used: the speed of reflection of the ultrasonic signal from moving blood particles is measured. In this way, you can measure the speed of blood flow in the uterus-placenta and placenta-fetus system, find out if there are any disturbances in the blood flow of the umbilical cord or placenta, calculate the frequency of the baby’s heartbeat, and determine whether the baby’s brain and other organs are receiving enough blood.

This is invaluable information for diagnosing many diseases, but at the same time, when performing Doppler ultrasound, the intensity of ultrasound is significantly higher than with ultrasound, up to 1500 mW/cm² with color Doppler versus a maximum intensity of 100 mW/cm2 for ultrasound.

Associated with this is a lot of controversy about the potential harm of Doppler ultrasound, or as this study is more simply called, Doppler. They are conducted both among scientists and practicing doctors, and among future parents.

There are two main types of Doppler: a duplex study, which looks at vascular patency and blood flow velocity, and a triplex study, which adds color to the image to more accurately determine the state of blood flow. The triplex method requires the use of higher ultrasound intensity, so it is used only when necessary.

• Many expectant mothers are concerned about the question of whether they can. And I want to take care of my appearance. We provide only comprehensive answers!
• It is very important to monitor your well-being during pregnancy and not miss even the slightest signal indicating changes in the health of the mother and fetus. Learn all about basal temperature and its changes.

Also, portable (fetal) Dopplers have recently appeared on the market, allowing you to hear the baby’s heartbeat and monitor its changes at home. The cost of such devices starts from 3 thousand rubles, but doctors do not recommend their purchase, since even small doses of ultrasound exposure with constant use of the device can theoretically have a negative effect on the development of the fetus, and in this case the risk is not justified for medical purposes. You will only be able to hear the baby’s heartbeat closer to the later stages of pregnancy, by which time any anomaly will have already been identified during standard ultrasound and Doppler ultrasound. Therefore, you should not expose your child to unnecessary radiation.

At what week can Doppler be done during pregnancy?

Doppler examination is prescribed in two cases. Firstly, for preventive purposes, once or twice, depending on the specific clinic, at 23-24 weeks of pregnancy and more often at 30-34 weeks. In addition, if indicated, Doppler can be prescribed at any stage of pregnancy. It should be noted that if the pregnancy progresses successfully, this study may not be prescribed at all; it is not included in the list of mandatory ones.

A preventive study is carried out in order to identify disturbances in blood flow in the umbilical cord or placenta. Most doctors are against performing Doppler before the 20th week of pregnancy, since the blood flow has not yet formed, so the readings will be unreliable and inaccurate. And it is safer to calculate the heart rate in the early stages using a regular ultrasound. Others, on the contrary, consider Doppler ultrasound to be a good way to identify pathologies in the development of the cardiovascular system in the fetus starting from the 5th week.

• Some maternal diseases: diabetes, kidney disease, hypertension, certain diseases of the cardiovascular system. In this case, the study can be very useful: for example, if the mother has diabetes, Doppler helps to more accurately determine the risk group and choose the right treatment method.

• Multiple pregnancy- also a risk factor, the study will provide additional information necessary to identify various pathologies.
• – if the cause is unknown, testing may help in diagnosis.
• Mismatch between fetal size and gestational age– the cause of this may be fetal hypoxia or other disorders that will be visible during Doppler sonography.
• Rh sensitization– Doppler can reveal increased blood flow in the umbilical cord, which may indicate the development of complications.
• Emerging suspicion of pathologies during cardiotocography or ultrasound - Doppler can give a more complete picture of the state of blood flow and help identify the causes of anomalies visible on ultrasound or cardiotocogram and, accordingly, choose treatment tactics.

In case of disturbances of blood flow in the uterus-placenta and placenta-fetus systems, three stages are distinguished according to the degree of severity: stage 1 - disturbances in one of the two systems, stage 2 - disturbances in both systems, but not critical, stage 3 - critical disturbances in the fetal-placental blood flow, uteroplacental blood flow may be impaired or preserved. In the latter case, it is often prescribed. In the first two, observation is mandatory, the rest depends on the nature and severity of the violations.

Is Doppler safe for the fetus?

On the Internet you can easily find a single, but often cited article stating that cell damage under the influence of ultrasound can occur at an intensity of more than 20 mW/cm², and when performing Doppler ultrasound, the intensity can reach 1500 mW/cm². This causes some women to refuse, even if they have indications for undergoing the study. It is worth saying that exposure to ultrasound at high intensity can indeed lead to tissue injury and the subsequent development of pathologies, since ultrasound puts pressure on tissues and heats them. But most studies claim that this occurs at intensities greater than 10 W/cm², which is significantly higher than the strongest color Doppler ultrasound.

In addition, over 30 years of using Doppler ultrasound during pregnancy, no negative consequences have been identified in the further development of the fetus. It should be taken into account that the radiation does not last continuously, but in streams for thousandths of a second, in addition, up to 50% is absorbed by surrounding tissues, so the actual impact on the fetus is much less than the values ​​​​prescribed in the characteristics of the devices.

You have been prescribed Doppler ultrasound: should you do it or not?

Any study provides information by influencing the object of study in one way or another and analyzing the response to this influence. Therefore, there are practically no absolutely harmless diagnostic methods. And for the same reason, many doctors do not recommend performing Doppler ultrasound “just like that” and “for reassurance”: radiation of any power has an effect on the child, although studies of specific consequences have not yet revealed. At the same time, Doppler examination often helps to identify pathologies in fetal development that can be missed on ultrasound, therefore, if any abnormalities are suspected, Doppler is prescribed without fail. In such cases, the risk of complications, even if they are possible, is much less than the risk that the child’s development is not going as expected, and without research the doctor will not know about this or will find out too late.

When prescribing any test, it is better to ask your doctor about why and how necessary it is. If you hear specific reasons in response, Doppler sonography is necessary; it can help in the timely diagnosis of many pathologies and subsequently save the life or health of your child. Whether or not to conduct this study during a normal pregnancy is up to you to decide. But in this case, when Doppler sonography is carried out as a preventive measure, one should limit oneself to two standard studies during pregnancy.

Throughout pregnancy, a woman must undergo a number of studies, including ultrasound. Using ultrasound, you can determine the condition of the fetus, the fullness of its development and, if necessary, prescribe treatment in a timely manner or make a fundamental decision regarding further pregnancy.

What is Dopplerography?

Many women who are carrying a child for the first time are interested in the question: “Doppler ultrasound during pregnancy - what is it?” At its core, Dopplerography is a type of ultrasound. The main purpose of the study is to assess the state of blood circulation in the arteries of the uterus, placenta and umbilical cord and determine the functionality of the fetal site. Doppler measurements make it possible to detect circulatory disorders, which has a very high prognostic value. This type of study allows you to determine the presence of placental insufficiency or identify delays in fetal development.

Diagnosis is carried out in the “mother-placenta-baby” format. This type of examination is mandatory for every pregnant woman.

Distinctive features

Types of research

The examination can be carried out in two modes:

1. duplex;
2. triplex.

Duplex mode - what is it? Doppler ultrasound during pregnancy in this mode allows you to obtain almost complete information about the vessel, assess its patency and, if there are any violations, identify them in a timely manner.

Triplex mode is just a color image that gives a complete picture of what is happening in the vessel under study. The results obtained in this mode are considered more reliable.

Normal indicators for diagnosis

For most women, there is little knowledge about what it is - Doppler ultrasound during pregnancy. They want to know what indicators are normal, and in what cases deviations may indicate problems with the fetus.

When diagnosing, three main indicators are taken into account:

1. SDO or S/D, that is, the systole-diastolic ratio. The indicator is calculated by dividing the maximum blood speed in systole (that is, recorded at the time of contraction of the heart muscle) by the speed that is recorded at the time of relaxation of the heart (that is, the diastolic indicator). For each vessel, the indicators are completely different.
2. Resistance index (RI). Determined by dividing the difference between the maximum and minimum blood flow velocity.
3. The pulsatility index (PI) is also determined by division, but the difference between the maximum and minimum speed is divided by the average blood flow for the entire cardiac cycle.

All these indicators are combined into one group - ISS, that is, vascular resistance indices.

Normal indicators for Doppler ultrasound during pregnancy

Uterine arteries:

Spiral arteries:

Umbilical cord arteries:

The tables indicate limit values, that is, a parameter that does not exceed that given in the table is considered normal.

If you find deviations from the norm, then you should not immediately panic. On the contrary, the doctor has the opportunity to start therapy as quickly as possible and prevent an unfavorable pregnancy outcome.

If abnormalities in the blood flow are detected

Detected deviations in Doppler ultrasound interpretation during pregnancy can confirm the presence and degree of disorders in the uteroplacental and fetoplacental systems.

If the first degree of blood flow disturbance is confirmed, there is a high chance that the pregnancy will still be full-term and the birth will take place naturally. But this is possible if complications and deterioration of blood flow do not arise before birth.

In principle, the first degree of deviation from the norm does not lead to fetal death. Typically, examinations are carried out at intervals of 2 weeks and CTG monitoring is done. The blood pressure of the expectant mother is subject to mandatory monitoring.

At the second stage of blood flow disturbances, problems are observed in the vessels of the uterus and umbilical cord. In such a situation, the woman and child require constant monitoring in a medical facility. It is possible to carry out therapeutic measures that will eliminate oxygen starvation of the fetus.

The third stage of blood flow disturbance is characterized by the fact that speed quantitative indicators tend to zero. Reverse blood flow may occur when the heart muscle is relaxed. In such a situation, the following measures can be taken:

Examination at home

Medicine and technology do not stand still. Today, even a device has been developed that allows you to monitor the development of the fetus at home. In this case, the question will not arise at what stage of pregnancy Doppler ultrasound is performed. Although you should not skip routine diagnostics, especially if you have a history of factors predisposing to worsening blood flow or chronic diseases.

A portable Doppler allows you to clearly hear the baby's heartbeat, which means peace of mind for the mother. If you have any suspicions about the health of the fetus, you can immediately consult a doctor.

What do pregnant women say?

Today, there is only a small percentage of women who avoid examinations in every possible way after conceiving a child, including ultrasound. In most cases, the expectant mother is ready to take care of the health of her baby. However, the reality is that even a blood test cannot be done for free.

The average price of Doppler ultrasound during pregnancy is 1.5-2 thousand rubles. If we talk about a full screening and extensive study, which can be supplemented by video recording, then such a “pleasure” will cost 4-5 thousand rubles. As a rule, the price fluctuates depending on the status of the clinic and location.

At the same time, the state clinic where the expectant mother is served must have an ultrasound machine with Doppler function. If a doctor sends a woman for examination based on a referral, it should be carried out free of charge.

Finally

When a child is desired and a woman is worried about his health, the question of how much a Doppler ultrasound during pregnancy costs does not arise. There will always be money to prevent possible disastrous consequences. The expectant mother should not neglect the doctor’s recommendations in order to carry the pregnancy to term and give birth to the baby on time.

Doppler is an ultrasound diagnostic that is used to study blood vessels and blood flow.

A specialist may prescribe a Doppler test to determine the following conditions:

• Deep vein thrombosis;
• Varicose veins;
• Diseases of the arteries of the upper and lower extremities;
• Aneurysm of the extremities;
• Diseases accompanied by occlusion of the carotid arteries;
• Aneurysm inside the abdominal cavity;
• Occlusive diseases within the iliac aorta.

Doppler ultrasound acts as one of the types of ultrasound diagnostics, which is used when examining pregnant women. Thanks to the information received after an ultrasound with Doppler, the sonologist receives the most accurate information. He is given the opportunity to prescribe the most effective treatment when determining the developmental delay of the baby.

Depending on the results of the Doppler ultrasound, the doctor decides on the appropriate course of treatment and permitting early delivery.

Doppler during pregnancy

During pregnancy, the expectant mother may be prescribed a Doppler ultrasound instead of a regular routine ultrasound. Thanks to modern technologies, this diagnosis is not much different from a conventional ultrasound examination. The latest models of ultrasound machines already have a built-in Doppler function.

There is no special training for performing Doppler during pregnancy. A pregnant woman only has to come to the procedure at the appointed time. After the expectant mother lies down on the couch, her stomach will be smeared with gel and the scanning will begin.

When carrying a baby, Doppler ultrasound helps determine placental blood flow within the established system Mother, Placenta, Fetus. Doppler differs from conventional ultrasound diagnostics in the following capabilities:

• Determining the health status of the child’s heart muscle;
• Determination of the quality of blood supply to the fetal vessels;
• Listening to the heartbeat;
• Detection (if any) of insufficiency in the functioning of the placenta;
• Determining the presence of hypoxia in the baby;
• Establishing the patency of fetal vessels;
• Examination of the lumen of the child's umbilical vessels.

All of the above studies are performed based on the device’s response to the speed of blood flow inside various umbilical vessels, brain arteries, fetal aorta, and uterine arteries.

The need for Doppler in pregnant women

During the period of bearing a child, an obstetrician-gynecologist monitors the condition of the expectant mother and baby. Doppler is considered a mandatory type of diagnostics for pregnant women. During the entire period of pregnancy it is prescribed 2 times. Typically, this examination is carried out at 22–24 weeks (1 time), 30–34 (2 times).

Additional indications for Doppler:

• Increased blood pressure;
• Multiple births;
• Smoking;
• Kidney diseases;
• Preeclampsia;
• Rhesus conflict;
• Pathologies during previous pregnancies;
• Preeclampsia;
• Chronic diseases of women;
• Inconsistency between the development of the baby and the gestational age.

Types of Doppler for diagnosing pregnant women

During pregnancy, Doppler examination can be carried out in two modes:

• Duplex. This option provides data about the vessel being studied, its patency, and the causes of the existing disturbance in the blood flow;
• Triplex. Provides a color image as a complement to duplex diagnostics. The bright picture shows the movement of red blood cells. This examination method is considered to be the most accurate.

The essence of Doppler work

Doppler is a device that is used to measure sound waves. These waves are reflected from objects in motion. The received information is processed via a computer. The monitor displays a color two-dimensional image, from which the specialist can determine whether the patient has difficulty with blood flow.

Doppler is used for:

• Studies of blood flow through vessels;
• Blood flow velocity measurements;
• Determination of vessel diameter;
• Measuring the size of an obstruction inside a blood vessel (blockage).

In a conventional ultrasound, ultrasonic waves are used, which are reflected from the vessels during the examination. As a result, a black and white image (B - mode) is displayed on the monitor. During ultrasound with Doppler, a specialist uses conventional ultrasound and Doppler in parallel. So, the doctor receives information about:

• Structure of blood vessels;
• Movement of blood cells through vessels;
• Areas with blocked blood flow;
• Blood flow rate;
• Direction of blood flow.

Preparation for the procedure

Most Doppler tests do not require special training unless they are performed in the abdomen. The doctor can list points with special instructions in the case when this is required by a specific type of ultrasound examination.

Thus, one of the requirements is to avoid eating food at night before the planned diagnosis. This point must be observed for the reason that ultrasonic waves are unable to penetrate through intestinal gases, just like through the air in the lungs.

At the beginning of the procedure, the patient lies down on a couch, exposing the area of ​​the body that will be examined. Then it is lubricated with a special gel to improve the transmission of ultrasonic waves. The only discomfort that the patient can feel is the sensor pressing on the diagnosed area of ​​the body. An image converted by the computer from the sensor signals appears on the monitor.

Diagnostics of various vessels

Doppler sonography is performed to determine blood flow disturbances inside the vessels. Depending on the area of ​​study, the following diagnostic options are distinguished:

Dopplerography of cerebral vessels

This procedure is called transcranial Doppler. The results of the study depend on the following factors:

• Specialist experience;
• Temporal bone thickness;
• Temple bone structure.

Doppler of cerebral vessels is necessary for the following pathologies:

• Spasms of cerebral vessels;
• Stroke;
• Poor blood circulation in brain tissue;
• Anomalies in vascular development.

Transcranial Doppler is also necessary for examining neurosurgical patients and monitoring patients after coronary artery bypass grafting. The specialist performs an assessment of the risk of embolism within the vessels.

Sometimes a doctor may recommend Doppler if a patient has:

• Dizziness;
• Migraine;
• Headaches of unknown origin;
• Vegetative-vascular dystonia.

Doppler of neck vessels

Duplex ultrasound of this area is necessary to detect diseases of the vertebral and carotid arteries. This procedure is prescribed to the patient by a neurologist. This diagnostic is indicated for the following indications:

• Noises of unknown origin in the head;
• The presence of transient ischemic attacks, characterized by temporary paralysis of the arm (hemiparesis), half of the body, and speech impairment;
• Manifestation of blindness in one eye (short-term);
• The appearance of periodic flickering before the eyes;
• Falls that are not explained by loss of consciousness;
• Headaches, the location of which is almost impossible to determine;
• No long-term loss of consciousness;
• Migraine;
• Dizziness;
• Balance disorders characterized by short duration;
• Visualization of atherosclerotic plaques inside various vessels.

Diagnosis of leg blood vessels

When performing duplex scanning of blood vessels in the legs, a specialist has the opportunity to determine the presence of diseases of the veins and arteries. Doppler testing of this area is prescribed by a vascular surgeon. This type of Doppler is indicated in the following cases:

• Diseases of the arteries inside the legs;
• The appearance of a feeling of numbness in the feet;
• Intermittent claudication. It occurs as a result of the manifestation of painful sensations inside the calf muscles. This limp appears during walking; with a short rest, its disappearance is noted;
• Feeling of chilliness;
• Increased level of sensitivity to temperature decrease;
• Swelling of the lower leg;
• Heaviness;
• Soreness of the veins;
• The appearance of pigmentation of the skin of the lower leg.

Doppler ultrasound measures how sound waves bounce off body tissue. The information is processed by a computer, and then the transcript is displayed on the monitor in the form of a two-dimensional color image. Doppler for pregnant women allows you to timely determine how correctly the fetus is developing and eliminate all possible threats to the life and health of mother and baby.

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

This ultrasound allows you to study blood flow, diagnose blood flow speed and vessel diameter. Modern devices operating at sound frequencies above 20,000 Hz, elusive to the human ear, are used to study the condition 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 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 examination. The duplex method allows you to examine the vessel itself, to see how correctly the blood flows through it. The triplex method is more advanced - it adds a color dynamic image of red blood cells to duplex ultrasound. This method is more accurate and gives the most detailed picture of the course of pregnancy.

Indications for Doppler

Today, a routine ultrasound 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 sufficient to ensure that the fetus is developing without deviations from the norm.

If necessary, the doctor may prescribe an additional study - Doppler. Indications for it are the following diagnoses:

• multiple pregnancy;
• pyelonephritis;
• hypertension;
• Rh conflict between mother and child;
• discrepancy between the state of fetal development and the timing of pregnancy;
• large fruit size;
• breech presentation;
• gestosis;
• chronic diseases in the mother (diabetes mellitus, thyroid dysfunction, autoimmune diseases);
• unsatisfactory results of cardiotocography;
• preeclampsia;
• 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 it. Such an examination cannot determine the sex of the child or display its image on the monitor. Doppler scans the vascular system of the placenta and baby to determine whether the baby is getting enough oxygen, how healthy the fetal 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 a timely manner, change the pregnancy management plan, and determine which birth 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, prescribe the correct treatment in a timely manner, and give recommendations to the mother that will alleviate her condition during pregnancy.

Is it necessary to undergo a Doppler test during pregnancy?

Unlike a regular ultrasound, Doppler is not mandatory. Despite this, doctors often prescribe it to expectant mothers 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 undergoing an ultrasound scan in the second trimester are multiple pregnancies, unsatisfactory tests, and Rh conflict.

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

A referral for Doppler is not a reason to assume that the pregnancy is progressing with abnormalities. Due to the high information content and accuracy of the results, today most obstetricians and gynecologists prefer Doppler. This procedure must be performed by a qualified specialist to obtain correct results.

How is the procedure done?

The examination itself takes 15–20 minutes. Before it you do not need to follow a special diet. The procedure is very similar to a regular 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 condition of the placenta and uterus and carefully examines the placental blood flow. Then he carefully examines the individual vessels of the brain and the umbilical cord. The objectivity of the results largely depends on the professionalism of the specialist.

The image on the screen shows the overall picture, which the specialist carefully studies. The device can also independently decipher the results and display it on the screen. Together, the professionalism of an experienced doctor and Doppler results allow us to learn a lot about the baby’s health and predict the process of childbirth.

Is it dangerous to perform Doppler?

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

In fact, ultrasound has no effect on the development of the fetus.

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

As an example, if there is an entanglement in the umbilical cord, the doctor prescribes a caesarean section to save the baby’s life and facilitate the birth process. The diagnosis of hypoxia is also not dangerous if it is detected in a timely manner. 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 ultrasound has made it possible to identify many pathologies, which has saved lives, preserved the health of millions of children, and made their parents happy.

During pregnancy, it is prescribed after the placenta has matured 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 blood vessels of a woman and the unborn child using a special Doppler sensor.

Unlike other methods for diagnosing vascular pathologies, Doppler ultrasound allows one to assess the performance of the middle cerebral artery and fetal aorta.

Ultrasound plus Doppler can detect even minor abnormalities in blood vessels, assess the speed and quality of blood flow, while a classic examination only determines the developmental features of the baby and its position inside the uterus.

Types of Doppler Dopplerographic

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 being provided with nutrition, and whether there are any disturbances in this process, pinching or squeezing of blood vessels. A 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 sonography allows you to examine the circulatory system of the fetus, how it develops according to the stage of pregnancy, and whether pathologies or abnormalities are present.

Triplex study

Triplex scanning helps you obtain the most complete and vibrant color image. The red and blue lines in the image indicate the highest or lowest speed of blood flow.

Duplex scanning

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

Shows:

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

A black and white image of the vascular bed is displayed on the monitor. The method is less accurate than triplex.

Indications for use during pregnancy

There are the following indications for ultrasound scanning:

• routine 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 from the Rudiamed channel talks in detail about the periods of the procedure during pregnancy.

By gestational age

Routine examinations in pregnant women must be done twice:

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

Ultrasound scanning is done when required, regardless of the timing, if the doctor considers it advisable to conduct Dopplerometry to eliminate risks during pregnancy or childbirth.

Pathologies of a pregnant woman

Diagnosis is mandatory if a pregnant woman has the following pathologies:

• diabetes;
• hypertension;
• lupus erythematosus;
• vasculitis;
• Hashimoto's thyroiditis;
• gestosis;
• kidney diseases;
• a history of frozen pregnancy or spontaneous miscarriage;
• conflict between the Rh factor of mother and child;
• unsatisfactory CTG results after 30 weeks;
• abdominal injuries.

Pathology in the development of pregnancy or placental abnormalities

The doctor may prescribe a study in the following cases:

• proximity of the umbilical cord rings to the baby’s neck;
• little/high water;
• suspicion of a brain or heart defect;
• presentation of the umbilical cord or its discrepancy to the proper length and/or thickness;
• placental infarction;
• the size of the fetus is less than normal;
• membrane attachment of the umbilical cord;
• premature placental abruption;
• single umbilical artery;
• hematoma or vasa previa of the umbilical cord;
• hyper/hypoplasia of the placenta.

How is it carried out?

Dopplerometry is performed as follows:

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

An ultrasound scan lasts 15-30 minutes.

Preparing for the study

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 Dopplerometry does not affect the result of the study.

Decoding the results

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

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

Movement of blood flow during the cardiac cycle

Doppler norms by week of pregnancy: tables

The results of Doppler ultrasound must be compared with the average normal values ​​contained in the tables, where:

• SDO is the systole-diastolic ratio (shows how many times systole exceeds 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 velocity inside the vessel).

Norms for changing the quantitative value of SDO in accordance with the timing of pregnancy

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

SDO in the uterine arteries

SDO in the umbilical cord

SDO in the middle cerebral artery

SDO of the fetal aorta

Norms for changes in the quantitative value of IR in accordance with the timing of pregnancy

Norms of IR in the uterine arteries

Norms of changes in IR in the umbilical cord arteries

IR in the fetal aorta

Norms for changes in the quantitative value of PI in accordance with the timing of pregnancy

PI of blood flow in the uterine arteries

PI blood flow in the umbilical cord

PI in the fetal cerebral artery

PI in the fetal aorta

Summary assessment of all indices for the main vessels at 28, 32, 36 and 40 weeks of pregnancy

Deviations from the norm and degree of violations

Description of signs of pathologies during pregnancy:

The most common pathology of fetal development is intrauterine hypoxia - insufficient oxygen supply to the child’s tissues and organs.

The inability of blood vessels to increase blood flow after placental maturation occurs in the following cases:

• disruption of uteroplacental blood flow;
• violation of fetal-placental blood flow (within subcritical and critical values);
• simultaneous disruption 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 makes a diagnosis of hypoxia and can draw a conclusion about its degree.

Is Doppler testing dangerous for a pregnant woman and 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 during 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” talks about cases of prescribing an examination.