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What does Doppler mean? Decoding the research results

Nowadays, diagnostics is becoming increasingly important. After all, a correct diagnosis will allow you not to harm your health and prescribe the right treatment. You can increasingly hear about ultrasound with Doppler.

Many people do not know that Doppler ultrasound (Doppler) is a type of ultrasound examination that allows you to diagnose diseases of the blood vessels. This type of examination is an indispensable examination for diseases of the arteries, varicose veins, vein thrombosis and aneurysm of the abdominal cavity or extremities.

Doppler during pregnancy

Often, a referral for Doppler ultrasound causes fear in pregnant women. Let's figure out what Doppler ultrasound means and what is the advantage of this study during pregnancy.

Doppler is one of the types of ultrasound diagnostics that allows you to listen to the baby’s heartbeat during pregnancy and determine the condition of the fetal umbilical cord vessels. You can obtain comprehensive information about the blood supply to the uterus and placenta. You can also see the overall health of your baby's heart.

As a rule, Doppler ultrasound is prescribed in the last months of pregnancy. But if a pregnant woman has diseases such as hypertension, diabetes, hypoxia, or renal failure, the test may be scheduled for another 20–24 weeks.

What is the difference between Doppler and ultrasound?

Gives the so-called “overall picture”, shows the structure of blood vessels. And ultrasound with Doppler shows the movement of blood through the vessels, its speed and direction. You can also see areas where blood flow is blocked for certain reasons. This allows you to take timely steps and prescribe effective treatment.

Modern ultrasound machines often combine two types of diagnostics. This allows you to obtain more accurate and informative results. Ultrasound plus Doppler is a duplex scan, or Doppler ultrasound (USDG).

Triplex scanning is characterized by the addition of a color image, which gives the study additional accuracy.

How is Doppler ultrasound performed?

To undergo a study not related to the diagnosis of abdominal organs, no special preparation is required. Although it is better to discuss all the details with your doctor in advance.

The examination does not cause any particular discomfort and usually takes no more than 30 minutes.

To summarize, we can say that Doppler ultrasound means a lot in matters of diagnostics during pregnancy. Helps to promptly identify pathologies in fetal development and save the lives of mother and child.

Nowadays, ultrasound examination is an important part of mandatory examinations of a pregnant woman. This examination is carried out at least three times throughout the pregnancy. And with almost every examination during an ultrasound, the doctor, in addition to the usual gray-scale mode, also uses a special technique that records and evaluates the blood flow of the fetus, called.

This is an ultrasound method with which the doctor records and evaluates the parameters of blood flow in the large vessels of the fetus and uterus: in the umbilical cord, in the middle artery of the fetal brain, in the venous duct and others according to indications. created on the Doppler effect, which consists in the reflection of ultrasonic waves emitted by a sensor from moving particles (red blood cells) and their registration by the device.

The device displays a blood flow graph or color display of blood flow on the screen. Based on the data obtained, a conclusion is drawn about how the fetus feels at the moment and further tactics for managing pregnancy are decided.

Indications for Doppler ultrasound during pregnancy

In the third trimester of pregnancy, Doppler is performed on all pregnant women in addition to the results for a full assessment of the condition of the fetus in the womb. For some women, such a study is indicated already in pregnancy, since during this period it is still impossible to assess the well-being of the fetus using any other methods other than Doppler.

Fetal Doppler ultrasound is indicated when there are concomitant maternal diseases, such as:

arterial hypertension,
high degree anemia,
large sizes,
genital infection,
respiratory failure,
heart failure.

Indications for Doppler ultrasound are also deviations in the normal development of pregnancy or pathology of the placenta:

threat of miscarriage or premature birth,
changes in the structure of the placenta identified by ultrasound,
discrepancy between the thickness or degree of maturity of the placenta and the gestational age,
placental presentation,
fetal growth restriction (IUGR),
large fruit,
Rhesus conflict,
ultrasound signs of intrauterine infection,
signs of hypoxia or heart failure in the fetus,
, great vessels, fetal kidneys,
entwining two or more loops of the umbilical cord around the neck.

There are no contraindications to Doppler ultrasound in pregnant women.

How is Doppler ultrasound performed during pregnancy?

Fetal Doppler is performed in exactly the same way and on the same device as a conventional gray scale 2-D ultrasound. Most often, these two types of research are done simultaneously.

The woman is asked to free her stomach from clothing and lie down on the couch. It is advisable to lie straight on your back, but if it is difficult for a pregnant woman to remain in this position for a long time or the fetus is turned in some atypical position, then the woman’s position on her side is allowed. The doctor applies a special gel to the area of the enlarged uterus and applies an ultrasound probe to the pregnant woman’s abdomen at various points in search of the vessels needed for examination.

In each case, the condition of both arteries of the uterus, the artery of the umbilical cord, and the middle cerebral artery of the fetus is mandatory. If necessary, then according to indications, a study of blood flow in the ductus venosus, thoracic aorta, renal arteries, umbilical vein, inferior vena cava, and fetal intracardiac blood flow may also be performed.

Using the sensor, the doctor finds and displays the vessel being examined on the screen, first in gray color, then turns on one of the Doppler modes and registers and evaluates the necessary blood flow parameters, then enters them into the study protocol.

The time is slightly longer than performing an ultrasound without Doppler and depends to some extent on the position and motor activity of the fetus. The calmer the child behaves, the faster and easier it is for the doctor to register his blood flow.

Decoding the research results

As a research method, it can give the doctor great and valuable information about how the baby feels in the womb.

To assess the state of hemodynamics, specially developed indices are used - the ratio of blood flow rates in systole and diastole. On the recorded blood flow graph, the doctor determines the maximum speed in systole - this is the highest point of the spectrum; the final diastal velocity is the lowest point of the spectrum; and average speed per cardiac cycle. After which the device calculates one or more indices by which the spectrum of blood flow is assessed: pulsatility index (PI, PI), resistance index (RI, RI) and systole-diastolic ratio (SDO, S/D).

The doctor compares the indicators obtained during the study with standard tables and draws a conclusion about the condition of the fetus, at what level the disorders occur and what they can lead to.

Table 1. Values of SDO and IR of the uterine arteries.

Gestation period, weeks	FROM TO	IR
12 -13	2,0-3,5	0,52-0,71
14 -16	1,9-3,1	0,48-0,68
17-19	1,7-2,6	0,44-0,62
20-24	1,6-2,5	0,41-0,61
25-31	1,7-2,4	0,40-0,59
32-37	1,6-2,3	0,35-0,58
38-40	1,4-2,1	0,32-0,55

Table 2. Values of SDO and IR of the umbilical cord arteries.

Gestation period, weeks	FROM TO	IR
14-15	5,0-8,4	0,80-0,88
16-17	4,0-6,8	0,74-0,85
18-19	3,0-5,3	0,67-0,81
20-22	2,9-4,4	0,66-0,79
21-24	2,8-4,3	0,61-0,76
25-27	2,5-3,8	0,60-0,75
28-31	2,3-3,0	0,54-0,70
32-36	2,0-2,9	0,51-0,65
37-40	1,8-2,8	0,45-0,64

Table 3. Values of SDO and IR of the middle cerebral artery.

Gestation period, weeks	FROM TO	IR
20-25	4,3-6,9	0,77-0,85
26-27	4,2-7,9	0,76-0,87
28-29	4,0-8,7	0,75-0,88
30-33	3,7-8,7	0,74-0,88
34-37	3,3-7,9	0,69-0,87
38-40	2,8-7,5	0,63-0,86

The most common causes of blood flow deficiency in the placenta are gestosis and arterial hypertension in women. Doppler ultrasound criteria indicating a violation of blood flow between the uterus and placenta:

decrease in speed in diastole below standard values,
increased IR in the uterine arteries,
the appearance of an early diastal notch on the graph of blood flow velocity in the arteries of the uterus.

The first signals of abnormalities in blood circulation between the developing baby and the placenta are a decrease in velocity in the arteries of the umbilical cord and an increase in resistance indices in them above the norm for a given gestational age.

There is a classification that describes the severity of placental blood flow disorders:

IA Art. – abnormal blood flow in the arteries of the uterus;
IB Art. – abnormal blood flow in the arteries of the umbilical cord, not reaching critical values;
II Art. - abnormal blood flow in the uterine arteries and umbilical arteries, not reaching critical levels;
III Art. – absence or negative values of blood flow in diastole in the umbilical arteries.

Ultrasound symptoms of circulatory pathology in the fetal MCA:

deviation from the norm of the resistance index and a decrease in the systole to diastole ratio (SDR) below normal;
absence and negative blood flow in diastole;
symptoms of “centralization” of fetal circulation.

Ultrasound symptoms of disturbances in the development of heart failure in the fetus:

the value of blood flow rates through all heart valves is below normal;
the appearance of functional insufficiency of the tricuspid valve;
registration of diastolic blood flow through the tricuspid valve “according to the adult type”.

Ultrasound symptoms of impaired blood flow in the umbilical cord vein:

the appearance of pathological pulsations synchronous with the fetal heart rate.

Based on information about the deviation of blood flow in certain vessels of the fetus, the degree of circulatory disturbance in the fetus can be determined:

1 tbsp. – compensated disorder: deviation of blood flow only in the MCA, with preserved blood flow in the thoracic aorta within normal limits;
2 tbsp. – subcompensated disorder: deviation of blood circulation in the thoracic aorta – increased values of the systole-diastolic ratio and resistance indices, absence or negative current in diastole;
3 tbsp. – subcompensated disorder: deviation of blood flow in the ductus venosus, absence or negative blood flow in the atrial systole phase;
4 tbsp. – decompensated disorder: signs of heart failure on Doppler.

In addition to all of the above, at 11-14 weeks of pregnancy, a change in blood flow in the venous duct often serves as a marker of fetal heart defects, which can lead to adverse pregnancy outcomes.

During development, it is also especially important to conduct Doppler measurements of the umbilical cord arteries and cerebral arteries (MCA) of both fetuses in order to prevent the development of feto-fetal transfusion syndrome in time. If the indices in the umbilical cord arteries in one fetus are higher than in the other, this indicates that the first baby is suffering from a lack of blood.

Artifacts during Doppler grometry

For objective physical reasons or due to imperfections in ultrasound equipment, image distortions - artifacts - may occur during ultrasound examination. They represent additional structures or geometric distortions, characterized by differences in size and shape from real prototypes.

This may be the appearance on the screen of buildings that do not actually exist, the absence of existing structures, their incorrect location, outline, or size. When studying fetal blood flow in the mode, some artifacts may also arise that may affect the correct interpretation of the conclusion.

Here are some of them:

Weakening of the color signal is the absence of formation of a color image of the vessel when the ultrasound image of the object is of poor quality, for example, when it is deep, the device is incorrectly configured, or the scanning angle is incorrectly set.

Pseudoflow artifact is the staining of a moving flow of any fluid located outside the vessels (movement of urine, amniotic fluid).
Eliminating effect - occurs when there is a mismatch between the high flow rate inside the vessel and the set frequency on the device. By setting the appropriate speed scale, the doctor eliminates this artifact.
A “flash” artifact (flash effect) is a burst of color signal caused by the movement of extravascular structures (intestinal peristalsis, air movement) or rapid movement of the sensor.
Twinkling effect (flickering artifact) - the formation of a color path behind an object with high reflectivity (stones, metal fragments).

Any competent ultrasound physician is aware of the possibility of various artifacts appearing during scanning and knows how to avoid them or distinguish them from real structures or phenomena.

Conclusion

Dopplerography of the fetus is a completely safe study for the expectant mother and baby from the second trimester of pregnancy. This is an excellent “assistant” that helps control the progress of pregnancy and quickly respond to the doctor if any deviations from the norm appear.

Survey histories

Natalya M.: “The necessary procedure!”

I want to tell you about the study that I had to undergo in the last month of pregnancy. During the third ultrasound, the results were not the best: the ultrasound showed early aging of the placenta, oligohydramnios, and entanglement in the umbilical cord.

To clarify my condition, I was prescribed a fetal Doppler. This examination was necessary to study the blood flow from mother to child; color mode can be used. The doctor explained to me that the indicators of this procedure are necessary because they are used to determine the norms of Doppler ultrasound during pregnancy:

Does the baby have enough nutrition through the umbilical cord?
Measuring the health of the fetus’s heart, organs, liver, brain;
The device will show whether there are knots on the umbilical cord;
Are the child's blood vessels sufficiently filled with blood?

A Doppler ultrasound is carried out in the same way as a screening ultrasound: the doctor uses a sensor to examine the condition of the fetus through the abdomen and pelvis, lubricating them with a special gel; the device creates a sound effect.

This requires certain equipment. There were no painful or unpleasant sensations during the procedure. Modern official medicine claims that ultrasound is absolutely safe for mother and child.

Taking into account the fact that all expectant mothers need to use screening, and there are no unpleasant consequences when using it, this statement is consistent with the truth.

The procedure lasted about 15 minutes, after which I was given a transcript with a doctor’s report, photos and videos.

I underwent the same examination three times during pregnancy. The doctor said that the Doppler effect is used in medicine to determine whether the child has enough blood supply. In addition, this was a way for me to see if there was good blood flow in the uterine arteries and placenta.

Specifically, for me, Dopplerography was needed to monitor how the fetus was developing, its main arteries, and whether it had hypoxia.

Previously, I was diagnosed with a deterioration in blood flow through the uterine arteries, after which a course of treatment was prescribed. Then she was examined again, which showed an improvement in blood flow.

The procedure follows almost the same standard as with a conventional ultrasound device, only a little longer. You need to pay for the procedure in the same way as for a regular ultrasound.

The only negative is that not every women’s consultation or clinic has a Doppler machine. Mine has this device, but to get to it, you have to wait a long time for your turn.

The examination itself is very informative and helps to detect various disorders, so it is better to undergo it, especially if your doctor has prescribed it for you.

Zhenya: “Expensive, but worth it”

During my second pregnancy, my doctor sent me to undergo a test called Doppler ultrasound, as she was alarmed by my CTG results.

This procedure should be done to find out the blood circulation in the “mother-placenta-fetus” system, what are the sizes of the vessels and the speed of blood flow in them, so it is very important.

This procedure is similar to a regular ultrasound examination. Doppler ultrasound is performed in the same way: the doctor applies acoustic gel to the stomach and looks with a sensor.

To be honest, I didn’t notice any difference. After completion, the doctor evaluates the results in order to determine in time whether there are any violations.

Doppler examination is prescribed only after 30 weeks of pregnancy. To carry it out, the doctor must have some suspicion of possible disorders: chronic diseases on the mother’s side, poor test results, after a suspicious CTG, multiple pregnancy.

I would like to separately note the cost of Dopplerography. Only for it I had to pay 850 rubles, not at the most expensive medical institution in my city, while a regular ultrasound costs 400. The prices are for 2015, they could have changed.

I believe that if you have any diseases or are simply worried about how the baby is developing, then it is worth undergoing such a procedure.

Maria: “It’s better to do it and not worry that something is wrong”

Fetal Doppler was performed twice. About halfway through my pregnancy, my gynecologist prescribed it. In Poltava, as I know, such a procedure is performed only in the new perinatal center, which is located on Zheleznaya Street 17a.

I immediately, about a week in advance, went to sign up. It cost 100 hryvnia, which was in 2016, and now, perhaps, even more expensive.

I came for the procedure. In fact, it turned out to be similar to the same ultrasound, only Doppler examination was more detailed. This is necessary to carefully study the condition of my baby’s heart. The doctor prescribed it again in a month, because something had not yet formed.

After the repeated procedure, they said that everything was now back to normal, and I calmed down.

If your doctor has prescribed a Doppler test, I advise you to still undergo it. This will help either to suspect a problem in time so that it can be solved in time, or simply so as not to worry. Be healthy!

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 9 months of gestation, a woman must undergo several routine ultrasound diagnostics. This is a mandatory and safe procedure, with the help of which doctors find out how the pregnancy is progressing, what position the fetus is in and whether its development corresponds to the term. Ultrasound with Doppler (Dopplerography, Doppler ultrasound) is a safe and informative research method that evaluates the quality of blood flow in the “uterus-placenta-fetus” system.

What is Doppler in pregnant women and how is it done? What are the indications for Doppler sonography? What do Doppler ultrasound results show during pregnancy and how to interpret them?

What is Doppler ultrasound during pregnancy and why is it needed?

Dopplerography is one of the methods of prenatal research that works like a regular ultrasound machine. This diagnostic method allows you to identify disorders in the development of the fetus. After Doplerometry, the doctor will identify the cause of the failure, determine treatment tactics, or decide on early delivery. This important research helps preserve the health of the expectant mother and the life of the fetus.

During the procedure, the frequency of the sound is assessed, which changes when reflected from a moving object (bloodstream). As mentioned earlier, it is used to assess the state of blood flow in the “uterus-placenta-fetus” system.

Doppler ultrasound differs from conventional ultrasound in the following ways:

During pregnancy, Doppler reacts to the speed of blood movement in different vessels (umbilical cord vessels, fetal aorta, cerebral arteries, uterine vessels).

During the scan, the doctor observes the movement of red blood cells (red blood cells) on a screen in a two-dimensional image.

There are 2 types of Doppler: duplex and triplex. Duplex mode allows you to assess the patency of blood vessels and identify the causes of circulatory disorders. Triplex mode presents a color picture with the movement of red blood cells. Ultrasound specialists prefer triplex scanning, which shows the most accurate results.

Indications for Dopplerography

After confirmation of pregnancy, a woman must register with a gynecologist. The doctor will monitor the course of pregnancy and develop an action plan for each patient individually. This takes into account the condition of the pregnant woman, fetal development, chronic diseases and bad habits of the mother.

During pregnancy, every woman must carry out other mandatory procedures. Dopplerography is an important study that is prescribed twice during the entire period if there are no additional indications.

As a rule, scanning is carried out during the following periods:

From 22 to 24 weeks;
From 30 to 34 weeks.

If during the next scheduled examination the doctor suspects various abnormalities, then an ultrasound with Doppler is prescribed several more times.

Dopplerometry is used in the presence of diseases in the expectant mother:

Arterial hypertension;
High degree of anemia (significant decrease in the number of red blood cells or hemoglobin in the bloodstream);
Large fibroids in the uterus;

Sexual infections;
Insufficiency of the respiratory organs (lack of complete gas exchange);
Functional failure of the heart.

In case of pathological development of pregnancy or abnormalities of the placenta, Doppler ultrasound is performed in the following cases:

Dopplerography is not contraindicated for expectant mothers.

How is Doppler ultrasound performed?

Dopplerometry does not require preparation from a pregnant woman. This procedure is almost no different from a regular ultrasound. The only difference from a standard ultrasound examination is that a woman has the opportunity to listen to the heartbeat of the unborn child and the sound of blood flowing through the vessels.

Interpretation of ultrasound results with Doppler during pregnancy

Using Doppler ultrasound, the doctor determines the condition of the fetus and the expectant mother.

To assess the movement of blood through the vessels, specially developed indices are used - the ratio of blood flow speed during contraction and relaxation of the heart muscles.

Using a graph, the specialist identifies the maximum blood velocity during systole(contraction of the heart), the final speed in diastole (relaxation of the heart muscles), as well as the average speed during systole and diastole. Then the device calculates one or more markers by which blood flow parameters are assessed: PI - pulsation index, IR - resistance index, SDO - systole-diastolic ratio.

After receiving the results, the doctor compares them with the norm and determines the condition of the unborn child. The norms for the results obtained during Doppler ultrasound during pregnancy for different indicators are presented in the tables below.

The norm of SDO and IR of the uterine arteries at different stages of pregnancy is presented in the table:

Week of pregnancy	FROM TO	IR
12 — 13	2 – 3.5	0.52 – 0.7
14 — 16	1.9 – 2.5	0.48 – 0.68
17 — 19	1.7 – 2.5	0.44 – 0.62
20 — 24	1.6 – 2.5	0.4 – 0.6
25 — 31	1.7 – 2.4	0.4 – 0.58
32 — 37	1.6 – 2.3	0.35 – 0.58
38 — 40	1.4 – 2	0.32 – 0.55

Norm of SDO and IR of umbilical cord vessels:

Week of pregnancy	FROM TO	IR
14 — 15	5 – 8.4	0.8 – 0.88
16 — 17	4 – 6.8	0.74– 0.85
18 — 19	3 – 0.53	0.67 – 0.8
20 — 22	2.9 – 4.4	0.66 – 0.78
21 — 24	2.5 – 3.8	0.61 – 0.76
25 — 27	2.5 – 3.8	0.6 – 0.75
28 — 31	2.3 — 3	0.54 – 0.7
32 — 36	2 – 2.8	0.5 – 0.65
37 — 40	1.8 – 2.8	0.45 – 0.64

Normal indicators of SDO and IR of the middle cerebral artery:

Week of pregnancy	FROM TO	IR
20 — 25	4.3 – 6.8	0.77 – 0.85
26 — 27	4.2 – 7.8	0.76 – 0.87
28 — 29	4 – 8.7	0.75 – 0.88
30 — 33	3.7 – 8.6	0.74 – 0.88
34 — 37	3.3 – 7.9	0.69 – 0.87
38 — 40	2.8 – 7.5	0.64 – 0.86

Most often, disturbances in blood flow in the placenta occur as a result of late toxicosis or hypertension in the expectant mother.

Insufficiency of blood circulation in the uterus-placenta system can be identified using the following parameters:

A decrease in the rate of diastolic relaxation below normal;
Increased resistance index in the arteries of the uterus;
Early diastolic notch on the uterine artery blood velocity graph.

Impaired blood circulation in the placenta-fetus system can be judged by a decrease in velocity in the umbilical cord arteries and an increase in resistance indices for a certain period of pregnancy.

Classification that describes the degree of placental circulatory disorder:

IA Art. – pathological blood flow in the uterine arteries;
IB Art. – impaired circulation in the blood vessels of the umbilical cord, which does not reach critical numbers;
II Art. – pathological blood flow in the arteries of the uterus and umbilical cord, not reaching critical values;
III Art. – absence of blood flow or negative indicators at the moment of relaxation in the vessels of the umbilical cord.

Pathologies of blood flow in the middle cerebral artery of a child are identified by the following ultrasound signs:

Deviation from the norm IR and a high difference between systolic and diastolic pressure (below normal);
Absence or negative blood flow at the time of relaxation of the heart muscles;
Centralization of fetal circulation.

Signs of a disorder of intracardiac blood flow with functional heart failure in a child:

Reduced blood flow through all valves;
Tricuspid valve insufficiency;
Diastolic blood flow through the tricuspid valve is “adult-type” in the fetus.

Pathological pulsations and synchronous heart rhythm in mother and fetus indicate a violation of blood circulation in the venous vessel of the umbilical cord.

To identify the degree of blood flow disorder in a child, it is necessary to take into account the disturbance of blood flow in different vessels:

In addition, at 11–14 weeks of pregnancy, venous blood flow is disrupted due to hereditary diseases or congenital pathologies of the fetal heart, which increases the likelihood of an unfavorable pregnancy outcome.

If there are two or more fetuses, an ultrasound with Doppler is also prescribed. At the same time, the arteries of the umbilical cord and brain of both children are examined. This is necessary to prevent feto-fetal transfusion syndrome (a complication of multiple pregnancies in which the blood flow of different fetuses is different).

If the indices in the arterial vessels of the umbilical cord in one fetus are greater than in the other, this indicates that the first child has a lack of blood.

Based on the above, ultrasound with Doppler is an absolutely safe diagnostic method for a pregnant woman and fetus from the 13th week. With the help of the study, the gynecologist monitors the course of pregnancy and quickly responds to any pathologies.

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