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Doppler for pregnant women: detailed information about Doppler. What is Doppler Ultrasound (Doppler)

The Doppler effect is based on the change in the frequency of the signal when reflected from moving objects, compared to the original. In this case, a signal is recorded in the form of a Doppler spectrum, that is, oscillations with different frequencies are “counted” for a certain time period and displayed in the form of luminous points of different intensity, which depends on the number of particles moving at the same speed. Since the Doppler effect allows you to estimate the speed of movement with great accuracy, in ultrasound (US) diagnostics, it is used to assess blood flow in the vessels. Such a study is called dopplerometry, or Doppler ultrasound, and can be carried out in two modes:

Permanent wave(there is a constant emission of ultrasonic signals)
Pulse(radiation goes in cycles of pulses).

In addition, it is possible to use color doppler mapping (CDI), consisting in the registration of blood flow velocities, coded in different colors, and superimposed on a conventional two-dimensional ultrasound image. The resulting images are called cartograms.

information Dopplerometry is becoming more and more widespread in obstetrics, as it allows using non-invasive(atraumatic, bloodless) ultrasound procedure to determine the condition of a pregnant woman and a child.

Norms of Doppler ultrasound during pregnancy

Violations in the utero-placental-fetal system occur due to improper implantation of the fetal egg and further development of the placenta, when changes in the spiral arteries do not occur in full. Doppler ultrasound abnormalities in the uterine arteries appear as a decrease in the diastolic component (exceeding the 95th percentile of normal). An important advantage of dopplerography is the ability, based on IR, to predict violations of the fetal-placental blood flow in (that is, we can assume the development, etc., and carry out adequate prevention).

After studying the uterine arteries, the umbilical cord arteries and fetal vessels (aorta and middle cerebral artery) are examined. This is necessary for a cumulative assessment of the severity of blood flow disorders in the mother-placenta-fetus system, as well as understanding compensatory possibilities(adaptive reaction of the body in response to the action of a damaging factor). The middle cerebral artery is examined using color doppler. The indications for the study of fetal-placental blood flow are generally similar to the indications for the study of blood flow in the uterine arteries (plus, non-immune fetal dropsy, congenital malformations, abnormalities of the umbilical cord vessels, pathological types of cardiotocograms, and others). To assess the fetal-placental blood flow, a number of indices are used:

Normally, the blood flow is the same in both arteries of the umbilical cord (each artery carries blood to about half of the placenta, so the difference in indicators should alert the doctor in terms of unilateral disturbances in the vascular network). Normal indicators of IR of the umbilical arteries are presented in the table.

Pregnancy period, weeks	5 percentile	50 percentile	95 percentile

Violations determined by dopplerometry

Violation of blood flow in the fetal-placental system with Doppler ultrasound is manifested by an increase in the vessels of the umbilical cord and aorta above normal values, while a study of blood flow in the middle cerebral artery of the fetus notes a decrease in indices below standard values. This is explained centralization of blood flow(that is, the blood supply to the vital organs of the fetus in the first place - the brain, heart, adrenal glands). Thus, dopplerometry of the vessels of the fetal-placental part of the blood flow allows at an earlier stage to determine changes in blood flow and to conduct timely therapy or careful delivery in the absence of the effect of treatment.

Classification of disorders of the utero-placental-fetal blood flow (according to Medvedev):

Idegree:

A- violation of the uteroplacental blood flow while maintaining the fetal-placental;

B- violation of the fetal-placental blood flow with preserved uteroplacental blood flow;

IIdegree: simultaneous violation of uteroplacental and fetal-placental blood flow, not reaching critical values;

IIIdegree: critical disorders of fetal-placental blood flow with preserved or impaired utero-placental blood flow.

There is a direct relationship between the degree of blood flow disturbance and the frequency and severity of complications (, intrauterine hypoxia), as well as the condition of the newborn. Each degree has its own characteristics of pregnancy management:

At I degree - dynamic monitoring and therapy that improves blood flow with mandatory control (cardiotocography - recording of the fetal heartbeat), ultrasound and dopplerometry 1 time in 5-7 days. In the absence of deterioration, the pregnancy is prolonged until the term of delivery. If the indicators worsen, daily monitoring of CTG and Doppler ultrasound is mandatory and, if necessary, early delivery. In the normal state of the fetus, childbirth is possible perviasnaturalis(through the natural birth canal).

At the II degree - CTG and dopplerometry are performed 1 time in 2 days, also with adequate therapy. With a deterioration in performance, the question of early delivery is raised.

III degree of violations is most often a direct indication for early delivery.

In addition to studying blood flow in the vessels, Doppler ultrasound is used to doppler echocardiography(study of blood flow in the fetal heart in utero). This method currently comes out on top in the study of hemodynamics in the fetal heart, while using color doppler and pulse Doppler with an assessment of three main parameters: speed, direction and nature (homogeneity, turbulence) of blood flow. This method allows you to identify the most complex congenital heart defects.

Doppler echocardiography is performed according to the following indications:

fetus and other pathological conditions of the fetus, where the assessment of intracardiac hemodynamics is an important prognostic sign;
Abnormal image of the heart on conventional ultrasound;
Clarification ;
Determining the nature and severity of hemodynamic disorders;
Presence of cardiac arrhythmias;
Expansion of the chambers of the heart during routine ultrasound.

Dopplerography is also used for suspected extracardiac (extracardiac) anomalies:

Aneurysm of the vein of Galen (large cerebral vessel);
Congenital malformations of the lungs, abdominal organs and kidneys;
placenta accreta(a pathology in which the placenta grows into the wall of the uterus and does not separate spontaneously in the third stage of labor);
Vascular anomalies(single umbilical artery and vasa previa).

Color Doppler and pulse Doppler are also used to diagnose such a serious pathology as hydatidiform mole, which is a special case trophoblastic disease (TB). TB is one of the most dangerous pathologies that usually manifests itself in the first trimester of pregnancy and can lead to the appearance of a malignant neoplasm ( chorioncarcinoma), which previously led to very high mortality. With this pathology, the normal development of the embryo does not occur, and the placenta grows in the form of bubbles that are filled with fluid. The most serious in terms of predicting the development of a malignant tumor is invasive(invasion - penetration into surrounding tissues) hydatidiform mole when abnormal tissue grows into the wall of the uterus. Since these structures are well supplied with blood, CDI has become widely used for diagnosis, which makes it possible to establish a diagnosis and carry out the necessary treatment at an earlier time.

Is Doppler Ultrasound Harmful?

Currently, there is a trend towards the use of technologies in ultrasound diagnostics that require high radiation power (this also applies to Doppler studies). Therefore, the issue of ultrasound safety is very acute, especially in pregnant women. Each ultrasonic sensor in the accompanying documentation contains the characteristics of the device for each mode of operation. In addition, there are regulatory documents that reflect the maximum allowable impact on tissues of ultrasonic waves. Ultrasound specialists should be guided in their work by the principle ALARA(As Low As Reasonably Achievable - as low as reasonably achievable), that is, each specialist must understand the capabilities of the device, but use them when the benefits outweigh the possible harm. To do this, on a number of devices indicators are installed:

Thermal index(warns of possible overheating of tissues during the study). This index is especially important in the study of bone tissue (the second and third trimester of pregnancy - the study of the bones of the skull, spine, limbs of the fetus), since it is most susceptible to heating.
Mechanical index(This index evaluates non-thermal processes in tissues during ultrasound - cavitation, which can cause potential tissue damage).

There is no exact data on the dangers and safety of ultrasound and, in particular, dopplerometry, since studies are not conducted on humans, but in the aquatic environment and on experimental animals. Therefore, the potential risk of conducting a study should be less than the useful information obtained.

Additionally The Doppler effect and techniques based on it are widely used in obstetric practice, as they allow not only to detect pathology in the mother-placenta-fetus system, but also to predict possible pregnancy complications.

H what is doppler ultrasoundduring pregnancy?Doppler of the fetus is one of the specific options for conducting an ultrasound examination, the main principle of which is the use of the "Doppler effect". Doppler studies are especially important for pregnant women.

It does not give such a complete and detailed picture of the state of the fetus, placenta and the mother's body, which only increases the diagnostic value of Doppler ultrasound. It is for this reason that dopplerography is an integral part of prenatal diagnosis of pathology of the fetus and placenta, although not at all stages of pregnancy.

The essence of the above "Doppler effect" is that ultrasonic waves, reaching moving objects, are reflected from them and give a highly informative picture on the screen of a special device. Blood has the fastest dynamic current in the human body.

On-screen 2D image carries information in the form of red bodies(i.e. erythrocytes in reality), which indicates the presence of blood flow in this area of soft tissues.

What can you find out with a Doppler ultrasound?

Using this diagnostic method, it is possible to assess the speed of blood flow through the maternal vessels, their diameter, and the pressure in their lumen. Doppler ultrasound allows you to identify and analyze the state of the cardiovascular system of the baby in the womb, the placenta, as well as the absence or presence of pathology of the umbilical cord vessels.

Particular importance is attached to the possibility of excluding the presence of intrauterine infection of the fetus and, in particular, due to wrapping the umbilical cord around the baby's neck. The cells of the nervous system of the body are the first to respond to an insufficient supply of oxygen, therefore detection of hypoxia at an early stage very important in the practice of any doctor-diagnostician.

Ultrasound without the use of the “Doppler effect” provides visualization of soft tissues without a dynamic assessment of the movement of blood through the vessels, i.e. absolutely static.

For diagnostic purposes, conventional ultrasound is sufficient, however, in cases where there is a need to determine blood flow, vessel diameter and blood pressure, Doppler ultrasound is much more effective. This efficiency is achieved, first of all, by the fact that the Doppler study evaluates the dynamic environment of the body.

Types of dopplerometry during pregnancy

duplex. This type of Doppler ultrasound is based on a combination of conventional and spectral complementary modes. The image is black and white. The specialist has the opportunity to assess the anatomical features of the studied vessels and the rate of blood flow in them. Thus, the patency of the vessels is assessed.

Triplex. The principle of operation of this variety is still based on a combination of two modes, but a color mode is added to them. Thanks to this addition, the assessment of the vascular bed has more accurate diagnostic results. Not only the anatomy of the vessel and its blood flow are assessed, but also the state of patency through a color image, which is more accurate and visual for a diagnostician.

How long does Doppler do? Doppler study is prescribed for pregnant women in late gestation(30-35 weeks of development), however, it is also possible to prescribe it earlier (20-24 weeks).

Indications for Doppler ultrasound at an early stage of pregnancy are, for example, a suspicion of a delay in the intrauterine formation of the systems and organs of the child, phytoplacental insufficiency. Early terms in the Doppler study are unscheduled, so the risk of detecting a certain kind of pathological changes is significantly increased.

For additional indications mandatory Doppler ultrasound for pregnant women include:

kidney pathology;
carrying a multiple pregnancy;
high-water or low-water pregnancy;
the presence of gestosis;
pathological pregnancies in the anamnesis of life;
bad habits of the expectant mother (smoking, alcoholism);
the propensity of the expectant mother to an increased level of blood pressure;
genetically and hereditarily determined pathology (and other hereditary hormonal disorders);
deviations from the norm of the result.

In order to facilitate preparation for childbirth, a Doppler study is performed in the prenatal period along with standard ultrasound. The procedure helps the doctor to think through the entire order of childbirth and assess the need for a caesarean section.

Doppler ultrasound differs little from the procedure for conventional ultrasound. Manipulation is performed by a specialized apparatus equipped with a sensor and a special program for processing the data received from each pregnant woman.

The information read by the sensor is processed and visualized on a special screen in duplex or triplex mode (depending on the type of device and the financing of the medical institution conducting Doppler ultrasound).

direction for research;
extracts from the previous ultrasound;
results of cardiotocorrhaphy;
ECG results;
personal documentation (passport, policy);
napkins (paper, wet) or towel;
diaper.

The pregnant woman is warned that her clothes during the Doppler ultrasound procedure should not be difficult to remove. A woman should freely expose the abdomen and, if necessary, the perineum. The patient is placed face up on the couch, then a line is applied to the area under study with a special transparent gel and, applying the apparatus to the site, diagnostic manipulations begin. The gel serves as an excellent tool for ensuring the inseparable contact of the device with the skin of a pregnant woman.

The duration of Doppler ultrasound is variable. In some cases, a diagnostician will only need a few minutes, while in others, the study may take up to half an hour. In particularly difficult cases, the diagnostic procedure may take even longer, due to the difficulty in determining pathological changes.

At the end of the study, the gel is removed with pre-prepared napkins or a towel. The ultrasound procedure is over, and now the main thing is to wait for the results.

Norm indicators and interpretation of doplerometry for pregnant women

Only a good specialist can give high-quality decoding Doppler results seen during pregnancy.

Produced assessment of a number of vascular formations y, which includes:

uterine arteries;
arterial and venous vessels of the umbilical cord;
middle artery of the child's brain;
child's aorta
fetal heartbeat.

Each vessel receives assessment on three main parameters: systole-diastolic ratio, pulsation index, resistance index.

The diagnostician is obliged to additionally assess the state of the vascular wall, the filling of the vessels, the speed and activity of blood flow in them, the state of oxygen saturation of the soft tissues.

There are many norms the three main parameters of dopplerometry listed above, depending on the week and month of pregnancy, which are listed in specialized tables.

In general, starting from the period of gestation, systolic-diastolic ratio should not exceed 2.4.

Resistance index Normally, it should be: for the uterine artery - less than 0.58, for the umbilical artery - less than 0.62, for the middle artery of the brain - less than 0.77.

What pathology can be detected with Doppler ultrasound: insufficiency of functioning of the placenta, fetal hypoxia, decrease in blood flow velocity, decrease in blood pressure in the vessels.

Is it harmful to conduct a Doppler study?

Important is the fact that Doppler ultrasound completely safe for health future child. The safety of ultrasound is evidenced by its low heating capacity and strict adherence to its dosing at each diagnostic session.

In addition, ultrasound is not dangerous to the health of the expectant mother. On the contrary, Doppler ultrasound is a necessary procedure that is not only painless, but also does not require a woman to worry before undergoing it. Doppler will only help in the diagnosis of possible pathologies absolutely harmless to health.

Video Doppler Ultrasound

For a better understanding of what the visualization of fetal blood flow looks like using Doppler ultrasound, we suggest watching this video.

Even more detailed information can be obtained through an active discussion on the issue of Doppler during pregnancy. Therefore, do not hesitate to ask each other your questions and give no less complete and useful answers. Share your own experience if you have already undergone a Doppler ultrasound procedure. Remember that the discussion helps not only you, but also those women who are just planning their first pregnancy in their lives.

Dopplerography is a method of ultrasound diagnostics. With its help, the doctor studies the parameters of blood flow in the large vessels of the uterus and fetus. As a result of the study, a graph is drawn up showing the change in blood velocity over time.

There are two types of Doppler ultrasound during pregnancy:

duplex. Provides for the use of standard and spectral modes, provides black and white images. During duplex dopplerography, the doctor can assess the condition of the vessels and determine the speed at which blood flows through them.
Triplex. It consists in the use of spectral, standard and color modes. Provides the most accurate diagnostic data. It is aimed not only at assessing the speed of blood flow and the state of blood vessels, but also at studying the patency of the latter - using a color image, it is easier for a doctor to notice deviations from the norm.

dopplerography

Doppler Modes

Doppler ultrasound during pregnancy can be performed in three different modes:

continuous wave. Ultrasonic waves go continuously.
Impulse. Waves are transmitted in cycles, that is, with interruptions.
Color mapping. In some parts of the vessels, the speed of blood movement is indicated by different shades.

How does a doppler ultrasound work during pregnancy

Expectant mothers who have received a referral for dopplerography are always interested in how doppler ultrasound is done during pregnancy. In fact, for them, this procedure is almost no different from the usual ultrasound diagnostics aimed at assessing the condition of the fetus. But here special equipment is used, equipped with a sensor, and a computer program for processing data. The information read by the device is analyzed and transmitted to the monitor screen in duplex or triplex mode.

A pregnant woman should take with her to the doppler:

referral issued by a gynecologist (if any);
results of previous Doppler ultrasounds;
towel or diaper (paper napkins);
passport;
compulsory health insurance policy.

Doppler device

It is good if the clothes of the expectant mother will be easy to remove, because she will have to completely expose her stomach.

During dopplerography, a woman lies on her back on a couch. A special transparent gel is applied to her stomach. After that, a sensor is applied to the treated area and they begin to drive it in different directions. The duration of the procedure can be from several minutes to half an hour. But during it, the mother does not experience any discomfort, especially pain.

When the doctor has finished examining the blood flow of the fetus and uterus, he will ask the patient to remove the remaining gel with a napkin or towel. After that, the pregnant woman can get up. After receiving the results in her hands, she should go to an appointment with her gynecologist.

When doppler is done during pregnancy

Doppler analysis during pregnancy in most cases is prescribed at 22-24 and 32-34 obstetric weeks. It is an obligatory stage of screening of the third trimester (then it is carried out immediately after cardiotocography). Some mothers are advised to undergo a Doppler test in the second trimester - if there are doubts about the normal development and well-being of the fetus.

Also indications for ultrasound with Doppler during pregnancy are:

anemia in the expectant mother;
high blood pressure;
the presence of a large uterine fibroids;
detection of sexual infection;
heart failure;
feeling short of breath;
intrauterine growth retardation;
the threat of miscarriage / premature birth;
pathological structure of the placenta, discrepancy between its size and degree of maturity to the established gestational age;
placenta previa;
giant or large fruit;
symptoms of fetal hypoxia;
suspicion of congenital malformations of the kidneys and heart in a child;
Rh-conflict (Rh-negative factor in the mother and Rh-positive in the baby);
repeated entanglement of the umbilical cord around the neck.

You need to understand that dopplerography is a safe diagnostic method, so all mothers can undergo it.

Norms of systole-diastolic ratio (LMS)

Results that can be obtained with Doppler

Dopplerography is aimed at assessing various vascular formations and parameters - uterine arteries, venous and arterial vessels located in the umbilical cord, the fetal aorta and the middle artery of its brain, and heartbeat. Each of the studied vessels is evaluated by the doctor according to the following criteria:

Systolodiastolic ratio (SDO). Calculated by looking for partial values of maximum heart rate and diastolic rate at rest.
Pulsation index (PI). Find out by dividing the difference between the maximum and minimum speeds by the maximum.
Resistance index (IR). It is the number obtained by dividing the difference between the maximum and minimum speeds by the average.

SDO, PI and IR are the main indices of vascular resistance. They allow the doctor to assess the state of blood flow.

Pulsation Index Norms (PI)

What does Doppler ultrasound tell?

In simpler terms, Doppler allows you to study:

Uteroplacental blood flow in two uterine arteries at once. Due to this, it is possible to understand whether the placenta is supplied with quality blood and whether the mother has preeclampsia.
Fetal-placental blood flow and blood circulation in the vessels of the umbilical cord. Doppler tells the diagnostician whether the blood flows normally through the vessels, whether anything is preventing its movement. Based on this, it is concluded whether the baby receives the nutrients he needs, whether he suffers from oxygen deficiency. If late toxicosis is diagnosed in a pregnant woman, an assessment of the fetal-placental blood flow makes it possible to establish the severity of the mother's condition.
Fetal blood flow in the internal carotid artery, middle cerebral artery, aorta. If, when studying the blood circulation in these systems, negative changes are found, it can be assumed that the child is in critical condition. Then the expectant mother is prescribed complex treatment in a hospital. If the gestational age allows, an emergency caesarean section is done.

Norms of the resistance index (RI)

It is important that the doctor conducting Doppler ultrasound additionally examines the condition of the walls of the vessels, the saturation of the soft tissues with oxygen. This information will be needed if a pregnant woman decides to prescribe medication.

To understand which Doppler indicators are normal and which indicate the presence of deviations, you need to study special tables. In them, taking into account the gestational age, the exact data that doctors are guided by are painted.

The difference between doppler and conventional ultrasound

Doppler is not the same as ultrasound. It is carried out only if the expectant mother has indications for this type of diagnosis. Dopplerography cannot determine the sex of the child, display its image on the screen. There are completely different tasks here.

Doppler during pregnancy helps the doctor to understand the state of the vascular system of the fetus, whether the placenta is functioning normally. In turn, this makes it possible to draw conclusions about whether the baby has enough oxygen and nutrients, whether he suffers in the womb.

A competent interpretation of the results of Doppler ultrasound is a guarantee of timely identification of possible risks, making important adjustments to the scheme of pregnancy management. Also, this type of diagnosis helps specialists determine the best tactics for childbirth.

Doppler ultrasound is not always done on the recommendation of a doctor. Some mothers who do not want to go to the hospital before the start of labor undergo such an examination on their own if the expected day of birth has passed, and the baby is in no hurry to be born. Thus, they can understand whether everything is in order with the fetus, whether there is hypoxia. And already on the basis of these data, decide whether to agree to the stimulation of labor or wait until the body itself starts the birth process.

Doppler allows you to understand whether you need to do a caesarean section

Can doppler harm the fetus?

Dopplerography is a safe diagnostic method. It does not in any way affect the development and well-being of the fetus. In terms of information content, Doppler ultrasound is priceless.

It accurately shows whether there is an entanglement and what kind (single, double, triple), whether the fetus experiences a lack of oxygen and nutrients. In some cases, only Doppler helps the obstetrician-gynecologist decide on the method of delivery and thus save the life of the child.

Dopplerometry is a diagnostic method that allows you to assess the prenatal state of the fetus by measuring blood flow in the uteroplacental complex. It gives information to the doctor and the pregnant woman about the well-being of the unborn child. Hemodynamics is measured in three vessels - the left and right uterine and umbilical arteries. If necessary, the current in the middle cerebral artery, aorta, venous duct of the fetus can be assessed. All information obtained during the measurement is presented in the form of certain values. Each stage of pregnancy has its own norm.

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Doppler ultrasound during pregnancy

The Doppler effect, used in medical practice, is based on the difference in the frequency of the initially sent signal and the frequency of the signal reflected from moving objects (in this case, blood in the vessels).

Such a study of a pregnant woman is carried out in the II and III trimester together with an ultrasound of the fetus. Dopplerometry is a mandatory component of assessing the condition of the unborn child, which gives an idea of how the baby feels in utero. The essence of this method is to measure blood flow parameters in the utero-placental complex (placenta and fetus).

The doctor first acquires an image of the vessels in gray scale mode, and then uses the CFM (color Doppler mapping) mode. The specialist sets the trial volume on the object of interest and takes digital values.

The main indicators for each evaluated vessel are blood flow velocity, systolic-diastolic, peak and resistance index. The values obtained during the study make it possible to clarify the nature and degree of hemodynamic disturbance.

Mandatory dates for dopplerometry are at the 19-21st week and the 30-34th, which corresponds to the second and third ultrasound screenings. According to the indications, additional procedures for the study of blood flow are prescribed.

Classification of blood flow disorders

There are three degrees of hemodynamic disturbance:

1. I degree consists of indicators A and B. In the first case, blood flow is disturbed in the arteries suitable for the uterus. In the second, pathology is noted in the vessels that go to the fetus (the resistance index in the umbilical artery exceeds the standard values for weeks).
2. II degree - hemodynamics is disturbed both in the uterine arteries and in the umbilical cord arteries.
3. III degree - failure in the blood flow is critical (the life of the child is in danger).

With a physiologically proceeding pregnancy, the movement of blood should not be disturbed. In the event of complications (pathology) of gestation, hemodynamics is disturbed to one degree or another. When the blood flow in the uterine arteries changes, the child's condition suffers to a lesser extent, does not pose an immediate threat, but requires dynamic monitoring in the form of dopplerometry every 10-14 days.

The situation is worse in violation of hemodynamics I B and II degrees. In this case, monitoring of the fetal condition is carried out in a round-the-clock hospital (daily monitoring of the fetal heartbeat, Doppler ultrasound monitoring every few days is required).

III degree of blood flow disturbance is very dangerous, it can lead to antenatal (intrauterine) death of the child. This situation requires active action on the part of medical professionals.

Clinical significance of Doppler study

Dopplerometry gives an idea of the functionality of the placenta, allows you to predict the consequences for the fetus. With circulatory disorders in both uterine arteries, as well as with II degree of growth of the child, the weight gain of his body may lag behind the normative values.

With complications during pregnancy, the study of blood flow occupies a significant place. With the development of toxicosis of the second half of gestation, placental insufficiency, Rhesus conflict, the measurement of hemodynamic parameters allows you to extend the period to the maximum possible values and determine the time of delivery. An important role is played by the study of blood flow during pregnancy against the background of chronic diseases of the mother (diabetes mellitus, arterial hypertension, kidney disease).

This research method in some cases, along with cardiotocography, helps to identify fetal hypoxia and allows you to take action. During the examination, it is possible to identify the entanglement of the umbilical cord of the child's neck and its multiplicity.

Dopplerometry is indispensable during pregnancy to detect the pathology of the fetal cardiovascular system. This will help to send the expectant mother to the appropriate medical center in time and keep the child healthy in the future.

Pregnancy Safety

The security of this method is of particular importance. Measuring blood flow during pregnancy does not harm the growing body. The number of Doppler examinations performed does not affect the health of the fetus.

The method helps to prevent a number of adverse consequences for the child and save his life, allows you to control blood flow during therapy.

Dopplerometry technique: what indicators are evaluated

In the process of studying blood flow velocities, the following indicators are evaluated:

peak systolic velocity (S);
maximum diastolic blood flow velocity (D);
resistance index (IR);
pulsation index (PI);
systole-diastolic ratio (SD).

These values change in each trimester of pregnancy, therefore, in order to decipher the obtained blood flow velocity curves, it is necessary to know the standard values for a particular period.

Doppler examination is carried out during the period of motor rest of the fetus, in the absence of breathing at a heart rate in the range from 120 to 160 beats per minute.

When assessing blood flow velocities in the uterine and umbilical arteries and the degree of resistance of these vessels, indicators such as the systole-diastolic ratio and the resistance index (resistance) are used. In the study of the middle cerebral artery of the fetus, the maximum systolic blood flow velocity in absolute values is used.

The study of hemodynamics in the venous duct in the first trimester makes it possible to identify a risk group for chromosomal pathologies.

The most informative is the measurement of 3-5 identical cardiocycles.

Doppler examination determines the heart rate (HR) of the fetus. Normal is 120-160 beats per minute. A persistent decrease in the frequency of contractions (fetal bradycardia) is an unfavorable factor that may indicate hypoxia.

High information content and accessibility, safety of this study make it indispensable during pregnancy. Deciphering the resulting velocity curves is not difficult for specialists.

Doppler ultrasound can measure the length of sound waves and how they bounce off different tissues in the body. The computer processes the received information, and after decoding in the form of a two-dimensional color image is displayed on the screen. This method of examination quickly determines how well the fetus develops.

Dopplerometry during pregnancy

What is Doppler Ultrasound During Pregnancy? A standard ultrasound scan visualizes soft tissue without assessing blood flow (static). To diagnose any pathology, such an examination is usually enough. However, in cases where it is necessary to establish the diameter of blood vessels, blood flow and blood pressure level, Doppler ultrasound is indispensable. The effectiveness of Doppler ultrasound is achieved due to the ability to assess the dynamic environment of the body.

Triplex study

What is a triplex doppler for pregnant women? During this procedure, three modes of operation are used - spectral, normal and color. Triplex doppler ultrasound during pregnancy provides an opportunity to assess the vascular bed, not only its anatomy or blood flow, but also its patency, which is ensured by the accurate color image of the device. So the doctor receives the most reliable picture of the development and current condition of the child.

Duplex scanning during pregnancy

What is doppler ultrasound during pregnancy duplex scanning technique? This view combines the work of two complementary modes - spectral and normal. The image received on the screen after the Doppler study is black and white. Thanks to the nuances, the doctor can assess the anatomical features of the vessels and find out if the speed of blood movement in them is normal. So, with the help of duplex scanning, an assessment of vascular patency is carried out.

What is a Doppler study during pregnancy

One of the specific methods of ultrasound is dopplerometry for pregnant women. The basic principle of the procedure is the Doppler effect, which consists in measuring the speed of reflection of ultrasound from blood particles in motion. It is important to do a Doppler ultrasound during pregnancy in order to determine the presence of abnormalities in the placenta in time, since it depends on whether the fetus will receive all the necessary substances for its development. This type of diagnostics allows detecting an early stage of hypoxia and preventing placental insufficiency (FPI).

Indications for carrying out

While a woman is carrying a baby, the gynecologist develops a plan for monitoring the fetus. Diagnostic procedures are prescribed based on the general health of the expectant mother, her bad habits and chronic diseases. However, there are mandatory procedures for every pregnant girl, one of which is Doppler ultrasound. In addition, the doctor, conducting a routine examination, may notice any deviations from the norm. Then an additional Doppler ultrasound is prescribed. The indications for the procedure will be:

kidney problems;
increase in blood pressure;
preeclampsia;
the presence of bad habits;
multiple pregnancy;
preeclampsia;
conflict of Rh blood of parents;
if the size of the fetus does not correspond to the gestational age;
negative results of cardiotocography;
the presence of diabetes mellitus and other chronic or hereditary pathologies.

How long do doppler doppler during pregnancy

Dopplerography can be prescribed during pregnancy in two cases - for prophylaxis (no more than two times, as a rule, is performed at about 23 and 30 weeks) or if there are indications. In the latter case, the procedure is done at any stage of pregnancy. Since Doppler ultrasound is not on the list of mandatory (not included in the screening), it may not be prescribed at all for some women. Prophylactic Doppler ultrasound is done to detect violations of the blood flow in the placenta or umbilical cord.

Is Doppler Ultrasound Harmful?

For three decades, the use of Doppler ultrasound during pregnancy has not revealed negative consequences. Ultrasonic radiation lasts in streams lasting a thousandth of a second, and not continuously. About half of the rays are absorbed by the tissues of the mother's body. The real impact on the child is minimal and does not reach the values specified in the characteristics of the device. So, Doppler ultrasound is a procedure that is harmless to the baby and his mother. Another confirmation of this is the low heating capacity of the device and strict adherence to radiation dosing during the examination.

When prescribing a study by a doctor, it is worth asking whether this is a necessary measure. If, in response, the specialist indicates specific reasons, the procedure should be done, since it will help to detect many pathologies in a timely manner and save the life of the baby. If the pregnancy is proceeding normally, and there is no reason for concern, the parents decide on their own whether to do a Doppler ultrasound. Despite the fact that the harm of this diagnostic method has not been proven, as a preventive measure, pregnant women should limit themselves to two standard studies.

How doppler is done during pregnancy

This procedure differs little from conventional ultrasound: it is carried out using a special apparatus equipped with a sensor and connected to a computer to process the latest data received. The information is decoded and displayed on the screen in triplex or duplex mode (depending on the device used). To do a Doppler ultrasound, a pregnant woman should take to the hospital:

results of examination of the heart (ECG, cardiotocorrhaphy);
direction for ultrasound;
passport, insurance policy;
the results of the last ultrasound examination in the form of an extract from the doctor;
towel or napkins;
disposable diaper.

When going to the procedure, choose comfortable clothes that will be easy to remove. During the Doppler ultrasound, the patient will need to lie on her back on the couch. After that, the doctor covers the woman's stomach with a special conductor gel and, applying the sensor to the required place, begins diagnostic manipulations. At the same time, the transparent substance ensures inseparable contact of the device with the patient's skin.

What doppler shows during pregnancy

Ultrasound Doppler diagnostics provides an opportunity to study the condition of the arteries and the entire vascular system of a pregnant woman (the degree of their patency, blood flow velocity, gap width, internal pressure). In addition, the technique helps to identify deviations in the development of the fetus in time, determine its general condition and how actively its organs are supplied with blood. Doppler ultrasound shows cord entanglement and fetal hypoxia.

Doppler ultrasound price

The cost of ultrasound Doppler examination varies within 1000-3500 rubles. The price differs depending on the location: if the procedure is performed in a good private clinic, it will be much higher. Doppler ultrasound can also be done on the basis of some maternity hospitals and specialized medical centers.