Ultraschall Med 2021; 42(05): 541-550
DOI: 10.1055/a-1452-9898
Guidelines & Recommendations

Doppler ultrasound in pregnancy – quality requirements of DEGUM and clinical application (part 2)

Article in several languages: English | deutsch
Renaldo Faber
1  Leipzig, Center of Prenatal Medicine, Leipzig, Germany
,
Kai-Sven Heling
2  Praxis, prenetal diagnosis and human genetics, Berlin, Germany
,
Horst Steiner
3  Praxis für Pränatalmedizin, Salzburg, Austria
,
Ulrich Gembruch
4  Obstetrics and Prenatal Medicine, University Hospital, Bonn, Germany
› Author Affiliations

Abstract

This second part on Doppler sonography in prenatal medicine and obstetrics reviews its clinical applications. While this has not become the initially anticipated screening tool, it is used for the diagnosis and surveillance of a variety of fetal pathologies. For example, the sonography-based determination of uterine artery blood flow indices is an important parameter for the first trimester multimodal preeclampsia risk assessment, increasing accuracy and providing indication for the prophylactic treatment with aspirin. It also has significant implications for the diagnosis and surveillance of growth-restricted fetuses in the second and third trimesters through Doppler-sonographic analysis of umbilical artery, middle cerebral artery and ductus venosus. Here, especially the hemodynamics of the ductus venosus provides a critical criterium for birth management of severe, early-onset FGR before 34 + 0 weeks of gestation. Further, determination of maximum blood flow velocity of the middle cerebral artery is a central parameter in fetal diagnosis of anemia which has been significantly improved by this analysis. However, it is important to note that the mentioned improvements can only be achieved through highest methodological quality. Importantly, all these analyses are also applied to twins and higher order multiples. Here, for the differential diagnosis of specific complications such as TTTS, TAPS and TRAP, the application of Doppler sonography has become indispensable. To conclude, the successful application of Doppler sonography requires both exact methodology and precise pathophysiological interpretation of the data.



Publication History

Received: 27 February 2021

Accepted: 16 March 2021

Publication Date:
27 April 2021 (online)

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