What is bridle during pregnancy. how do bridles during pregnancy. norms and decoding of bridging during pregnancy. Use of Doppler ultrasound to assess fetal health

08.08.2019

Unfortunately, at present, absolutely healthy pregnant women with a perfectly flowing period of gestation are quite rare. With the constant growth of concomitant pathology in expectant mothers and an increase in the frequency of complicated pregnancy, methods for assessing the intrauterine state of the fetus are becoming increasingly important. The successful development of the baby directly depends on the absence of circulatory disorders in the mother-placenta-fetus system. An indispensable method for assessing the uteroplacental and fetoplacental blood flow is the ultrasound scan during pregnancy.

What is USDG during pregnancy

Doppler ultrasonography stands for Doppler ultrasound and is a use-based diagnostic method. Ultrasonic waves of a certain frequency, reflected from the moving blood cells in the vessels, change their frequency. It is the change in this ultrasound parameter that makes it possible to assess the blood flow.

What are the types of Doppler ultrasound

There are two types of USDG:

Color Doppler mapping.
Spectral (pulse) Doppler ultrasonography.

In color mapping, moving blood elements are colored on the screen in red (blood flow to the sensor) and blue (blood flow from the sensor) of different intensity depending on the blood flow velocity. With the help of color mapping, you can assess the blood flow in the smallest vessels of the placenta, uterus and fetus, distinguish between veins and arteries.

Spectral Doppler imaging shows changes in blood flow in a graph.

There are two types of Doppler ultrasound:

Duplex scanning uses conventional ultrasound in combination with color mapping or spectral Doppler.
Triplex scanning is characterized by the use of two Doppler methods with conventional ultrasound.

What can be seen with Doppler ultrasound

When performing Doppler ultrasound, it is possible to assess the blood flow velocity in the vessels of the mother-placenta-fetus system, their diameter and patency, and also to characterize the fetal heart rate. On the mother's side, two uterine arteries are examined. Doppler ultrasound of the fetus includes an assessment of blood flow in the umbilical arteries, spinal artery, aorta, and ductus venosus.

Who needs dopplerography

Doppler ultrasonography is not required for all pregnant women. It is carried out only according to indications from the mother or fetus. The reasons for the appointment of a Doppler study are:

maternal diseases (arterial hypertension, heart disease, diabetes mellitus, severe anemia, antiphospholipid syndrome, thrombophilia);
stillbirth, preeclampsia, photoplantation insufficiency and other complications in past pregnancies;
gestosis;
premature aging of the placenta;
lack of water;
intrauterine growth retardation;
multiple pregnancy;
entanglement of the umbilical cord around the neck of the fetus;
with Rh-conflict;
post-term pregnancy.

What is the Doppler procedure?

No preparation is required before the Doppler procedure. In the overwhelming majority of cases, ultrasound is performed in addition to the usual ultrasound examination.

The pregnant woman lies on her back. If a woman has a pronounced manifestation of the inferior vena cava syndrome, then the position on the side is allowed. The sensor is placed on the abdomen. For the study, a special gel is used to improve the conduct of ultrasound and obtain a clearer picture. The procedure does not take much time and is absolutely painless and safe.

When can you do a Doppler ultrasound during pregnancy

The period for Doppler sonography in each case is established by the doctor based on the woman's health status and the characteristics of the course of this pregnancy. With a short period of gestation, a Doppler study is not very informative, but it can help in diagnosing the threat of termination of pregnancy.

During the first screening, ultrasound is an important aid in determining chromosomal diseases and other abnormalities in the development of the fetus. The appearance of reverse diastolic blood flow in the venous duct, an increase in the pulse index in combination with an expanded collar space in the period of 10-13 weeks indicates chromosomal pathology.
Starting in the second half of pregnancy, uteroplacental and fetoplacental blood flows can be assessed to determine the condition of the fetus. Doppler is assigned individually with a certain frequency depending on specific indications. In the second trimester of pregnancy, in the presence of maternal diseases or complications from the fetus, Doppler examination can be prescribed from 18-20 weeks of pregnancy. With Rh-conflict or fetofetal syndrome with monochorionic pregnancy and other complications, control examinations can be performed once every 2-4 weeks before delivery.
In the third trimester of pregnancy, Doppler may be prescribed as an additional study as part of the third screening at 32-36 weeks.

Deciphering the results of ultrasonic scanning

The analysis of the graphical image of blood flow velocities is the basis for decoding the USGD data. The defining moment is the difference in blood flow velocity in systole and diastole. Based on this, the following parameters are calculated:

Systolic-diastolic relationship.
Ripple Index.
Resistance index.

Comparing these indicators with the normative ones, the doctor draws conclusions about the uteroplacental and feto-placental circulation. With obstructed blood flow, these parameters are increased.

Based on the data obtained, a pregnant woman may need hospital treatment and even early delivery.

Today, pregnant women undergo many more different examinations than 20-30 years ago. Medicine has made great strides forward and is now able to prevent many diseases of the baby at an early stage of their development. Doppler ultrasonography during pregnancy is one of the studies that are carried out in order to assess the condition of the child.

How is the USDG performed?

Doppler ultrasound (Doppler ultrasound) is a procedure that assesses the state of blood flow, for example, in the heart or other organs, and examines the condition of the baby. It is needed, in particular, to assess the work of the placenta. Doppler ultrasonography today is practically the only way to study the vessels of the expectant mother and baby.

Pregnant women are prescribed this procedure in order to prevent intrauterine oxygen deficiency, which can cause pathologies in the development of the central nervous system of the fetus. Lack of air contributes to deviations in the development of other internal organs of the baby.

Thanks to the ultrasound scan of the fetus, it is possible to identify a heart defect from the second trimester. The Doppler ultrasound procedure is done in conjunction with a planned ultrasound. Most ultrasound machines have just such a function.

Indications for ultrasound examination:

pathology of the placenta;
dropsy;
chromosomal abnormalities;
a lot or lack of water;
multiple pregnancy;
rhesus conflict;
gestosis;
injury to the abdomen of a pregnant woman;
diabetes mellitus and the like.

Doppler ultrasonography is performed according to indications and is not prescribed so often. With normal gestation, this study is optional. As a rule, doctors in this case prescribe it for 31-33 weeks or do not insist on it at all.

Doppler ultrasound is done in the same way as ultrasound: a transducer is guided over the pregnant woman's abdomen, which is available in every modern ultrasound diagnostic device. No preparation is required for this survey.

Decoding UZDG

Now let's look at how ultrasound is deciphered during pregnancy.

Initially, a woman is examined in consultation to establish the fact of her “interesting” position and fetal development. This happens three times: at the first call, at about 12 and 21 weeks. Doppler is usually not used in this case. Research finds out:

term of delivery;
the size of the fetus;
condition of the uterus.

Based on the diagnosis, the doctor draws up a pregnancy management scheme. Then examinations are assigned. All results of USDG during pregnancy are entered into the woman's medical record. There are certain norms according to which all conclusions regarding the bearing of a child are recorded.

Planned Doppler sonography of the fetus is done already at 33 weeks. Sometimes doctors prescribe it earlier, having established that the placenta has already formed. If there are doubts that the baby is not developing normally and is not receiving enough nutrients, the examination is carried out at any time from 16 weeks.

Blood flow is assessed by a number of indicators.

Resistance index (IR). To calculate this indicator, you need to identify the difference between the minimum and maximum speed. The final figure is divided by the maximum.
Diastolic and systolic ratio (SDR). In this case, the ratio of the blood flow velocity in the vessels is assessed in two phases - diastole and systole.
Ripple Index (PI). To evaluate it, the difference between the minimum and maximum velocities is divided by the average blood flow velocity.

For the study, all numbers are compared with the tables of the prescribed standards. The average IR of the baby's aorta is 0.75. The mean IR of the cerebral artery is 0.773. The degree of circulatory pathology when decoding the ultrasound scan is determined taking into account these norms. It also turns out which type of blood flow (placental-fetal / AUC, uteroplacental / BMD) is not working properly.

There are 3 degrees of circulatory disorders:

IPC and PPK have critical violations;
IPC and PPK are violated, but not critical;
only one blood flow is disturbed.

The doctor, by decoding, draws conclusions about the degree of the condition of the fetus.

How to find out how pronounced hypoxia is?

To find out, you need to compare the Doppler ultrasound standards with the specific result obtained during the study.

For example, increased indicators of the umbilical cord indicate placental insufficiency. This also indicates the presence of preeclampsia. And if the resistive index (IR) and systolic-diastolic ratio (SDR) in one fetus is greater than in the other (with multiple pregnancies), this means that this child is suffering.
Increased LMS and IR in the uterine arteries indicate that the unborn baby does not have enough oxygen. This is fraught with delayed development of the baby.
Increased IR and LMS in the aorta indicate that the developing child is experiencing discomfort. This happens with a post-term pregnancy or mother's illness.
A decrease in LMS and IR of the carotid and cerebral arteries means that the fetus is in critical condition. Blood only goes to the main organs. Urgent measures are needed (), otherwise the child will die.

Blood flow disorders

First degree
Violation of blood flow in the arteries of the umbilical cord. This condition is treated by stimulating blood circulation. The expectant mother is prescribed special medications. In parallel, a blood test is performed for the ability to coagulate.
Violation of blood flow in the uterine arteries is a condition that is practically not treated with medication. With this diagnosis, doctors recommend spending more time outdoors, breathing air and monitoring your diet. Sports activities and yoga are also shown.
Second degree

Simultaneous (non-critical) violation of blood flow in the umbilical cord and uterine arteries. In this case, the woman must be admitted to the hospital and prescribed drug therapy. This condition is dangerous because it is fraught with intrauterine death. As a rule, in modern practice it is possible to avoid such grave consequences, but sometimes incidents do happen.

Third degree

Violation of blood flow (critical) in the umbilical cord and uterine arteries. This degree is very dangerous for the baby. In 50% of cases, intrauterine death occurs. For this reason, doctors perform a caesarean section to save the fetus. Treatment here may be completely ineffective. Moreover, delay here is highly undesirable. At this level, normal childbirth in most cases leads to the death of the child.

Does the procedure harm the fetus?

Nowadays, medicine often uses technologies based on radiation. Therefore, the issue of the safety of their use for women and children is relevant. Note that all devices must be accompanied by documentation regarding their operation and compliance with the requirements. Every physician serving such equipment should be well versed in it.

It is important to remember that Doppler ultrasound is a very important medical procedure that allows you to diagnose all kinds of pathologies in both a woman and an unborn child. It is UZGD that today makes it possible to identify deviations at 33 weeks of pregnancy. In particular, conventional ultrasound is not able to demonstrate a complete picture of the development of the baby and the condition of the mother. KGT for the indicated period is not applied at all. If a doctor directs you for a Doppler ultrasound, you should heed his advice. Inaction can be much more dangerous than the designated research.

With the constant growth of concomitant pathology in expectant mothers and an increase in the frequency of complicated pregnancy, methods for assessing the intrauterine state of the fetus are becoming increasingly important. The successful development of the baby directly depends on the absence of circulatory disorders in the mother-placenta-fetus system. An indispensable method for assessing the uteroplacental and fetoplacental blood flow is the ultrasound scan during pregnancy.

USDG stands for Doppler ultrasound and is a diagnostic method based on the use of the Doppler effect. Ultrasonic waves of a certain frequency, reflected from the moving blood cells in the vessels, change their frequency. It is the change in this ultrasound parameter that makes it possible to assess the blood flow.

What are the types of Doppler ultrasound

There are two types of USDG:

Color Doppler mapping.
Spectral (pulse) Doppler ultrasonography.

Spectral Doppler imaging shows changes in blood flow in a graph.

There are two types of Doppler ultrasound:

Duplex scanning uses conventional ultrasound in combination with color mapping or spectral Doppler.
Triplex scanning is characterized by the use of two Doppler methods with conventional ultrasound.

What can be seen with Doppler ultrasound

Who needs dopplerography

Doppler ultrasonography is not required for all pregnant women. It is carried out only according to indications from the mother or fetus. The reasons for the appointment of a Doppler study are:

maternal diseases (arterial hypertension, heart disease, diabetes mellitus, severe anemia, antiphospholipid syndrome, thrombophilia);
stillbirth, preeclampsia, photoplantation insufficiency and other complications in past pregnancies;
gestosis;
premature aging of the placenta;
lack of water;
intrauterine growth retardation;
multiple pregnancy;
entanglement of the umbilical cord around the neck of the fetus;
with Rh-conflict;
post-term pregnancy.

What is the Doppler procedure?

No preparation is required before the Doppler procedure. In the overwhelming majority of cases, ultrasound is performed in addition to the usual ultrasound examination.

When can you do a Doppler ultrasound during pregnancy

During the first screening, ultrasound is an important aid in determining chromosomal diseases and other abnormalities in the development of the fetus. The appearance of reverse diastolic blood flow in the venous duct, an increase in the pulse index in combination with an expanded collar space in a week indicates chromosomal pathology.
Starting in the second half of pregnancy, uteroplacental and feto-placental blood flows can be assessed to determine the condition of the fetus. Doppler is assigned individually with a certain frequency depending on specific indications. In the second trimester of pregnancy, in the presence of maternal diseases or complications from the fetus, Doppler examination may be prescribed for a week of pregnancy. With Rh-conflict or fetofetal syndrome with monochorionic pregnancy and other complications, control examinations can be performed once every 2-4 weeks before delivery.
In the third trimester of pregnancy, dopplerometry can be prescribed as an additional study as part of the third screening.

Deciphering the results of ultrasonic scanning

Systolic-diastolic relationship.
Ripple Index.
Resistance index.

Comparing these indicators with the normative ones, the doctor draws conclusions about the uteroplacental and feto-placental circulation. With obstructed blood flow, these parameters are increased.

Based on the data obtained, a pregnant woman may need hospital treatment and even early delivery.

Norms of Doppler examination of the fetus - decoding Doppler ultrasound during pregnancy

Ultrasound diagnostics is not the last among the diagnostic procedures adopted in obstetric and gynecological practice. Its use makes it possible to timely identify and prevent the lion's share of pathological abnormalities in the condition of the mother and child in her womb.

Doppler ultrasonography during pregnancy, as the main diagnostic procedure

Doppler ultrasound (Doppler) is based on the Doppler method, it consists in examining the patient with ultra-frequency waves and analyzing the difference in signals (emitted and reflected). In this case, a moving erythrocyte mass is a reflective medium for ultrasound. The result of the study is a Doppler gamma, which allows you to assess the blood flow and its characteristics. Thanks to Doppler ultrasound, you can not only get the results of the examination in the form of a graphic display, but also hear the blood flow.

Velocity, as the main characteristic of blood movement, differs in characteristic data for the central and parietal flows, in addition, it is not the same for different types of vessels at the time of contraction or relaxation of the vascular wall. Thus, knowing the norms of indicators, in the process of conducting ultrasound during pregnancy, it is possible to evaluate such values as the blood flow rate in the arteries of the umbilical cord and uterus, placental blood flow and blood flow in different vessels of the fetus. And to determine the pathology at the preclinical stage.

If necessary, ultrasound scanning during pregnancy can be supplemented with duplex and triplex scanning - the CDC method. The reliability of the data of the uteroplacental and placental-fetal blood supply, obtained for diagnostic purposes by the Doppler method, is more than 70%.

Indications for Doppler ultrasonography during pregnancy

The need for a Doppler examination during the gestation period is determined by the presence of chronic diseases of the mother, revealed during pregnancy, violations of the work of her organs and systems. The pathological course of pregnancy is also a reason to go for an ultrasound scan. Doppler ultrasonography is performed for the following main indications:

diabetes;
pathology of the urinary system;
vasculitis;
dystonia;
frequent fainting, pallor of the skin;
development of preeclampsia;
the presence of Rh-conflict;
little, polyhydramnios;
pathology of the placenta;
exceeding the gestation time;
intrauterine fetal hypoxia, including those caused by the cord entanglement;
suspicion of chromosomal abnormalities;
suspicion of SZRP;
burdened obstetric history;
the age range of the expectant mother is under 18 and over 35.

Diabetes mellitus in pregnant women necessitates a Doppler examination

A referral to an ultrasound scan does not mean the presence of a critical pathology of the child in the womb and the threat of termination of pregnancy. This is just a way to make sure that the gestation is proceeding normally. And also that the existing pathological processes are under control.

Preparation, dopplerography procedure and contraindications

Preparation for the procedure is very simple and does not require specific activities. This study does not require diet, drug withdrawal, special sleep and rest regimen. No requirement for liquid intake. This means that it can be carried out at any time convenient for the patient. You need to have a diaper with you, make a couch. As well as dry wipes to remove excess acoustic gel.

Doppler ultrasound, like most ultrasound diagnostic procedures, is performed in the supine position. The duration of the study is from 15 to 30 minutes. Do it using an external sensor. The area of the skin that will be in contact with the sensor is lubricated with a special gel, then the doctor, placing the sensor at different angles, conducts an examination.

Ultrasound diagnostics has no absolute contraindications. Relative contraindications to ultrasonography are deep wounds or an infectious lesion of the skin at the site of contact with the sensor.

Pregnancy period, when it is supposed to do an ultrasound scan

Before the 20th week, such a survey is not informative. The procedure becomes possible after the placenta has formed. The most informative data are Doppler ultrasound at the time of intensive growth and development of the child in the womb (27-34 weeks).

For the earliest possible detection of the pathology of the "uterus-placenta-fetus" system, Doppler ultrasound is prescribed in the interval from the 20th to the 24th week of pregnancy. The scan results will be relative and will need to be clarified. More accurate, reliable and complete information will be obtained from the 30th to the 34th week in conjunction with a screening ultrasound.

The most complete and reliable information on the dopplerogram can be obtained in the period from the 30th to the 34th week of pregnancy.

Doppler data analysis

Deciphering the Doppler study (blood flow graph) is carried out by a qualified specialist who, highlighting certain areas, calculates relative indices showing the resistance of the vessels and describing the nature of the blood supply in the system of the uteroplacental and placental-fetal vascular bed. It also compares the received data with the established norm.

The most complete data are obtained in the aggregate study of the entire utero-fetal blood circulation: uteroplacental blood flow, placental-fetal blood supply, blood flow through the main vessels of the fetal brain and uterine arteries. The diagnostic criteria for circulatory disorders in the "uterus-placenta-fetus" system are:

slowing down the blood flow in the uterine arteries during diastole;
slowing / stopping / reverse flow in the arteries of the umbilical cord during diastole.

In severe conditions, similar changes are found in the systolic period. The following relative indices are assessed: systolic-diastolic ratio (ratio of blood flow rates in the period of systole and diastole), resistance index (IR - vascular wall resistance), PI (pulsation index).

Decoding of Doppler indices, standards

As a result of the research, the average standards of the relative indices, calculated according to the indicators of the blood flow velocity, have been derived. They depend on the gestational age.

The standards for the LMS are indicated in the table:

The average IR of the child's aorta in the womb is 0.75. For the middle cerebral artery from 22 weeks before delivery, the IR is 0.773.

Based on the above norms, when decoding, the degree of circulatory pathology in the "uterus-placenta-fetus" system is determined. And it is also established which type of blood flow (uteroplacental / BMD, placental-fetal / PPK) is disturbed. Three degrees of impaired blood circulation between the uterus and the baby in its cavity have been established:

one of the types of blood flow of the BMD or AUC is impaired, while the other is preserved;
both types of blood flow are impaired, but the impairments are not critical at the moment and require immediate intervention for the purpose of correction;
both types of blood flow (BMD or AUC) are impaired, the level of impairment is critical.

According to the obtained decoding of the Doppler study, the obstetrician-gynecologist leading the pregnancy judges the degree of suffering of the child in the womb during a number of pathological processes: the maturing Rh-conflict, the degree of vascular pathology of the mother and the child in her womb with the progression of diabetes mellitus, hypertension or myocardial disease. Also, the doctor has the opportunity to assess the state of the vessels of the fetus during multiple pregnancies, and determine whether the development of one fetus is at the expense of the other.

Good afternoon. Tell me, how will it affect the fetus that at 18 weeks I did a 3D ultrasound scan with a Doppler? I am very worried about this!

Doppler ultrasound can assess uteroplacental-fetal blood flow. If, according to the doctor's indications, you underwent Doppler ultrasonography, there were probably reasons for that. This study does not pose a danger, the only thing is that for such a period it is not informative enough.

Hello pregnancy of the week. Doppler umbilicalis 1.05> N

Uterina dextra 1.08

Uterina sinistra 0.62

Celebri media 2.19

Tell me what it means

04.12.2016 at 11:21

Hello pregnancy of the week. Doppler umbilicalis 1.05> N

Uterina dextra 1.08

Uterina sinistra 0.62

Celebri media 2.19

Tell me what it means

Hello! Is it possible to do an ultrasound scan with a CDC for a period of 4-5 obstetric weeks, to assess blood flow and prescribe drugs by a hematologist? Or is it harmful?

Attention! All information on the site is provided for informational purposes only and is for informational purposes only. For all issues of diagnosis and treatment of diseases, you must consult a doctor for full-time consultation.

How is it done and how does the ultrasound scan during pregnancy

Having conceived a child, all women undergo an ultrasound examination without fail. Doppler ultrasonography during pregnancy is simply necessary to obtain information about the blood supply to the fetus.

What is Doppler ultrasonography during pregnancy

Doppler ultrasound during pregnancy Along with a typical ultrasound examination, fetal ultrasound with Doppler ultrasound is included in the mandatory diagnostic program for pregnant women during the entire period of pregnancy.

What is and how is the ultrasound of the fetus done?

As part of monitoring pregnancy, patients are assigned a fetal ultrasound examination in order to exclude intrauterine hypoxia (oxygen deficiency), leading to problems associated with the development of the central nervous system of the fetus.

Deciphering USDG during pregnancy

Having applied to the antenatal clinic, the patient undergoes the first ultrasound examination to determine the very fact of pregnancy. In addition, high-frequency diagnostics determines:

Next, the doctor draws up a preliminary pregnancy management scheme, prescribes a planned examination, which is part of the comprehensive prenatal diagnosis. After each scanning procedure, the transcript and the results of Doppler ultrasonography during pregnancy must be attached to the medical record of each patient.

How do they do and how does Doppler ultrasonography go during pregnancy

The principle of this method is quite simple. The whole essence of the study lies in the ability of red blood cells (erythrocytes) to reflect ultrasonic waves sent through a special sensor.

How long is the ultrasound scan done in pregnant women?

If the pregnancy is proceeding normally, if there are no abnormalities, then prenatal diagnosis is carried out in three stages (one procedure for each trimester of pregnancy).

hypertension accompanied by high blood pressure and hypotension - low blood pressure

fetal development does not correspond to the gestational age, intrauterine growth retardation was revealed

What is USDG during pregnancy

If you have been prescribed an UZDG, do not be intimidated by the formidable abbreviation. UZDG stands for Doppler ultrasound. Consider what it is, how and why this study is carried out and how it differs from a conventional ultrasound scan.

What is it and what is it for

In fact, ultrasound is a type of ultrasound. Standard ultrasound diagnostics uses ultrasonic waves (piezoelectric effect). Doppler ultrasound also uses ultrasound, but through the Doppler effect. In other words, ultrasound and ultrasound are different types of the same procedure, differing in application, but not in performance.

The object of the USDG study is vessels, the brain, blood flow, as well as the search for plaques, blockages, and other disorders of the circulatory system. As a rule, the decision on the need for such a study is made by a neurologist or vascular surgeon.

This study will also be useful for expectant mothers. Doppler ultrasonography helps to detect pathologies of the parent and child in the early stages, allows you to assess the risks of pregnancy and eliminate a number of potential disorders even before delivery. In particular, the timely conduct of an ultrasound scan allows detecting oxygen deficiency (hypoxia) in a child, which in the future can cause disorders of the central nervous system. Hypoxia is treatable if detected early, which makes diagnosis quite important during pregnancy.

Who is assigned

In fact, USDG is useful not only for making a diagnosis, but simply as a preventive measure. A simple and painless examination will help detect:

impassable arteries;
atherosclerosis;
inflammation and other vascular lesions;
decreased wall elasticity;
congenital anomalies (for example, hypoplasia of the arteries).

During pregnancy, such a diagnosis provides an additional opportunity - the study of the circulatory system of the fetus, the detection of violations even at the stage of fetal maturation. Doppler ultrasonography is an optional procedure, but it should still be done. In particular, the study is intended for:

finding out the size of the fetus;
finding out the state of the placenta;
viewing the location of the umbilical cord loops, especially near the head and neck of the fetus;
assessing the amount of amniotic fluid;
checking the size of the child, as well as his heart and brain;
testing for Rh-conflict between the organisms of the mother and the child.

Also, in any risky situations for pregnancy: with recent injuries, abdominal injuries, preeclampsia.

Soreness of the procedure

The procedure is completely painless, it is done even for babies. The only contraindication is skin damage, dermatitis, inflammation at the site of contact of the body with the ultrasound sensor.

How long is it done

The study is considered safe, therefore it is done for adults and children, there are no contraindications.

It is believed that performing an ultrasound scan for pregnant women for up to 16 weeks is a completely useless procedure. At such an early date, the diagnostician will not receive practically any valuable information, and the intrauterine position (of the fetus, umbilical cord loops) is still unstable and will change over time.

How to prepare

There is no preparation for diagnostics as such. The only thing is to exclude the intake of vascular drugs, smoking, alcohol the day before.

How the research is done

The ultrasound scan is practically no different from the ultrasound we are used to. The patient also lies on the couch, a sensor with a gel is also passed over him. The only difference is that they may be asked to hold / speed up your breath, shake your head. And you cannot move, speak without the doctor's request - you can knock down the received data. To diagnose blood vessels, the patient lies on his stomach, the doctor examines the neck, and during pregnancy, the patient lies on his back, the doctor examines the abdomen.

The duration of the diagnosis varies depending on the area under study and the state of the vessels. On average, this is 30 minutes - 1 hour, for fetal diagnostics - up to half an hour.

Norm and interpretation of results

Doppler ultrasound evaluates two parameters: blood flow and permeability of the vessel walls. Also, the diagnostician assesses the condition of the arteries (midbrain of the fetus, umbilical and uterine) and the aorta.

The patient receives the results of the study in the form of a plate, where his indicators are compared with the norm. Often deviations from the norm in one direction or another are marked with a colored marker. There are criteria such as:

The last two indices together form the ASC - vascular resistance indices. This indicator on the study of the aorta indicates the speed of blood flow. A decrease in the ISS indicates an increased flow rate, and an increase, respectively, is the opposite.

High indicators of LMS and IR (in the uterine arteries and umbilical cord) indicate an insufficient number of terminal villi (an adapter between the mother's uterus and the placenta with the baby), which indicates placental insufficiency (fetal disorders) or uteroplacental insufficiency (disturbances from uterus).

An increase in the same parameters in the fetal aorta and umbilical cord can be caused by diabetes mellitus, as well as the incompatibility of the Rh factors of the mother and the child. If a woman is carrying several children, then an increase in LMS and IR in the umbilical cord of one of the fetuses may indicate a developmental disorder of this child.

It is not entirely correct to talk about the clear norms of each parameter, since they change depending on the week of pregnancy, the object of study (brain, arteries). The doctor can correctly decipher the USDG data, and you should contact him.

Diagnosis of this type is simple, safe and inexpensive. At the same time, it allows you to detect and eliminate a number of pathologies that are practically not amenable to treatment after childbirth. UZDG is exactly the case when it is better to play it safe and do it.

Children should not be better off without consulting a doctor. You can do worse. When my son had diarrhea, we had a pediatrician.

to know the process according to natural ethics, and then according to the doctor's birth with friends and relatives, to evaluate their dimensions.

the tragedy of bipedal locomotion gave rise to the problem of childbearing: duration and passivation in the vertical of the female.

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What is revealed by fetal Doppler ultrasonography?

Ultrasound diagnostics in obstetrics is practically the only reliable and safe research method that helps the doctor assess the development and condition of the fetus in the womb. With the development of technology, more and more new methods come to medicine. Doppler ultrasonography can be considered one of them, although the beginning of its use was about a year ago, but it has become actively used by doctors in obstetrics relatively recently.

What is Doppler ultrasound (USDG).

Doppler ultrasound is a technique that is usually used during an ultrasound scan in order to assess the state of blood flow in the vessels of various organs and tissues. It is based on the Doppler effect. It can be used to identify the displacement of blood particles, measure blood flow velocities in vessels, and evaluate various specially developed blood flow indices.

Types of UZDG.

There are two main types of Doppler ultrasonography. The first is color mapping, when moving blood particles in the vessels on the screen of the device are colored in different colors depending on the direction and speed of blood flow. When particles are directed towards the sensor, the vessel is colored in shades of red, when blood moves in the direction opposite to the sensor, in different shades of blue. The higher the speed, the brighter the color. With the help of CDC, the vascularization of organs, pathological formations is assessed, small vessels are searched, arteries and veins are differentiated.

The second type is spectral or pulsed Doppler sonography. With the help of it, the blood flow is recorded in the form of a curve graph, and then various mathematical calculations are carried out with it.

In addition, depending on the number of simultaneously applied modes, duplex and triplex ultrasound Doppler scanning are distinguished.

Doppler ultrasonography. Common carotid artery spectral doppler

Duplex scanning combines two modes: conventional gray-scale ultrasound and one of the Doppler modes, which simultaneously show the image in real time. Thus, visualization of organs and blood vessels is obtained with the simultaneous obtaining of information from color or spectral Doppler ultrasonography.

In triplex scanning, in addition to the gray-scale image, two Doppler modes (color and pulse) are simultaneously turned on.

In obstetrics, when assessing the condition of the fetus, as a rule, duplex scanning is used.

When pregnant women are prescribed Doppler ultrasonography in the fetus.

In the third trimester of pregnancy, Doppler ultrasonography is performed for all pregnant women during the 3rd screening in addition to the CTG results. For some women, Doppler ultrasonography is indicated already in the second trimester of pregnancy, since during this period no other methods can still assess the well-being of the fetus.

Indications for the ultrasound scan for the fetus may be concomitant diseases or some conditions of the mother: arterial hypertension, the threat of termination of pregnancy or premature birth, high-grade anemia, large uterine fibroids, infection of the genital tract, respiratory and heart failure.

Fetal circulation, color Doppler mapping

Indications for Doppler ultrasonography may still be changes identified in the placenta: changes in the structure of the placenta detected by ultrasound, the discrepancy between the thickness or degree of maturity of the placenta and the gestational age, placental presentation.

In addition, Doppler sonography is indicated if there are signs of any abnormalities in the development of the fetus itself: VGRP or vice versa, a large fetus, Rh-conflict, ultrasound signs of infection in the fetus, signs of hypoxia or heart failure, congenital heart defects, great vessels, kidneys, 2 and more umbilical cord loops around the neck.

There are no contraindications to Doppler ultrasonography in pregnant women.

Why is such a survey carried out?

Doppler ultrasonography (USDG) is used to significantly improve the quality of diagnosis and assess the severity of functional disorders in the fetus. With the help of USDG, you can quickly and safely assess the condition of the fetus. After Doppler ultrasonography, the doctor can more reasonably determine the further tactics of pregnancy management, as well as resolve questions about the best timing and method of delivery, if there are any abnormalities in the development of the fetus.

Preparation for research.

Doppler ultrasonography of the fetus does not require any special training for a pregnant woman.

It is worth noting only that the examination of the fetal blood flow should be carried out during the period of motor calmness of the fetus, with a rhythmic and normal heart rate corresponding to its gestational period. Respiratory movements, movements of the body and limbs of the child are the reason for the registration of an unstable blood flow graph in the studied vessel, according to which it is impossible to correctly calculate the velocity parameters.

After eating by the mother, the fetus, as a rule, becomes more active, therefore it is recommended to carry out Doppler sonography a couple of hours after eating.

How does an ultrasound scan with dopplerography go?

The study of fetal blood flow is carried out in the same way as a conventional gray-scale ultrasound. Most often, these two types of research are performed simultaneously.

The woman should free her belly from clothes and lie down on the couch. It is advisable to lie directly on your back, but if it is difficult for a pregnant woman to be in this position for a long time or the fetus is in some atypical position, it is allowed to lie on its side. The doctor applies the gel to the area of the uterus and applies the ultrasound probe to the pregnant woman's abdomen at various points in search of the main vessels needed for examination.

With each Doppler study, the condition of both uterine arteries, the umbilical cord artery, and the middle cerebral artery of the fetus must be studied. According to the indications, a study of the venous duct, thoracic aorta, renal arteries, umbilical cord veins, inferior vena cava, intracardiac blood flow of the fetus can be carried out.

The doctor displays the necessary vessel on the screen first in gray, then turns on one of the Doppler modes, registers and studies the necessary blood flow parameters, and then enters them into the study protocol.

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

What the UZDG can show.

Oxygen deficiency of the fetus can occur as a result of deviations in the transport of oxygen to the tissues of the fetus at different stages:

with maternal hypoxia;
with placental insufficiency;
with changes in the umbilical cord;
with diseases of the fetus.

Doppler ultrasonography, as a research method, can give the doctor great and valuable information about how the baby feels in the womb. The doctor compares the indicators obtained during the study with standard tables and draws a conclusion about the condition of the fetus, about the level at which violations occur and what they can lead to.

After pregnancy, changes in blood flow in the ductus venosus often serve as a marker of chromosomal diseases or fetal heart defects, which can lead to adverse pregnancy outcomes.

In the II and III trimesters, an increase in the values of peripheral resistance indices (IR, PI) or the ratio of blood flow velocity in systole to diastole (SDO) in the arteries of the woman's uterus indicate a violation of the uteroplacental blood supply.

Fetal Doppler Blood Flow Velocity Curves

The values of LMS or IR of the umbilical arteries are higher than normal, as well as the identification of a spectrum of blood flow with zero or negative values of velocities indicate a violation of the fetal-placental blood flow.

Evaluation of blood flow in the middle cerebral artery of the fetus reveals cerebral circulation disorders in the fetus.

Where to go with the results.

Having received the conclusion of the ultrasound doctor with Doppler ultrasound, the woman should contact the obstetrician-gynecologist, in whom she is observed about this pregnancy. He, in conjunction with other studies, will conduct a general assessment of the condition of the fetus, and if necessary, prescribe the necessary treatment or further observation.

Conclusion.

Doppler ultrasonography is a valuable and non-invasive method for examining pregnant women. It allows you to receive important diagnostic information in a complicated course of pregnancy and thereby prevent or begin treatment of the developing pathological condition of the fetus during pregnancy.

To be sure of the health of the unborn baby, a pregnant woman undergoes many examinations from the moment of registration in the antenatal clinic and before childbirth. It is recommended that in each trimester be sure to take a general blood test, a general urine test, and a biochemical blood test. Once, for a period of 10-14 weeks, blood is taken from a pregnant woman to determine the likelihood of Down syndrome in a baby, and about 20 weeks - to determine the level of antibodies to infections (herpes, cytomegalovirus, chlamydia, toxoplasma). If any deviations are found, the tests will have to be repeated after the course of treatment.

In the last weeks of waiting, special procedures allow you to assess the condition of the baby - whether he receives enough oxygen, whether he is lagging behind in growth, whether there is an umbilical cord entwined around the baby's neck. For this purpose, ultrasound, fetal Doppler ultrasound and cardiotocography are used.

Doppler ultrasonography during pregnancy

Doppler ultrasound (USDG) is an ultrasound scan that allows you to assess the level of blood flow in the mother-placenta-fetus system. According to the results, pregnancy complications are established or predicted - placental insufficiency, gestosis, preeclampsia and others.

How does Doppler sonography work?

In the middle of the 19th century, the physicist Doppler discovered that a sound wave is reflected from moving objects differently from stationary ones. More than 100 years later, such an important discovery was applied in medicine, when the ability to perform Doppler ultrasound was added to the first ultrasound machines. Blood is a heterogeneous liquid, but a mixture of plasma and cells. These cells are constantly moving at high speed through the vessels, which means that the Doppler effect is applicable to them. The examination shows the presence of blood flow in a particular vessel, its direction and intensity, determines the diameter of an artery or vein.

The use of USDG in obstetrics makes it possible to judge the uteroplacental blood flow and the work of the umbilical cord, namely:

right and left uterine artery,
vessels of the umbilical cord of the fetus - two arteries and a vein,
middle cerebral artery of the fetus.

What parameters are determined by the USDG?

To reliably assess the state of the uteroplacental blood flow, the following digital parameters are used:

resistance index - an indicator that allows you to judge the diameter of the vessels,
systolic-diastolic ratio - a coefficient reflecting the uteroplacental blood supply and the state of the umbilical artery in different phases of the heartbeat (contraction and relaxation),
the pulsation index is a special parameter for assessing the elasticity of the vascular wall of the umbilical arteries.

The rates of these indicators are presented in special diagnostic tables in accordance with the weeks of gestation.

Thus, the ultrasound scan allows early detection of abnormalities in the baby's blood supply and selection of the optimal treatment for the pregnant woman so that the baby is born healthy.

The interpretation of the results is performed by the doctor of ultrasound diagnostics - his opinion is reflected in the conclusion of the examination protocol. More detailed comments on the baby's condition will be given by the observing gynecologist.

What can be detected with Doppler sonography?

In a state of nutritional deficiency, research shows the centralization of blood flow - the redistribution of circulating blood to vital organs. In this case, it is necessary to resolve the issue of conservative treatment or delivery, depending on the duration of pregnancy and the significance of the disorders.

Normal blood flow (left); violation of blood flow in the placenta (right)

There are III degree disorders of the uteroplacental-fetal blood flow:

IA: decreased uteroplacental blood circulation with normal placental-fetal,
IB: decreased placental-fetal blood flow with a sufficient level of uteroplacental blood flow.
II: moderate disturbance of the uteroplacental and placental-fetal blood supply.
III: a pronounced decrease in fetal blood flow, regardless of the level of the uteroplacental.

Uteroplacental blood flow is assessed by the state of the uterine arteries, and placental-fetal blood flow is assessed by the umbilical cord vessels.

The presence of such pathologies as intrauterine growth retardation syndrome, chronic hypoxia, and after birth - perinatal damage to the central nervous system directly depends on the degree of deviation from the norm. Often there is such an anomaly as a single artery of the umbilical cord. The diagnostic accuracy is 70-80%.

These deviations are very severe and may require treatment of a newborn child in the intensive care unit, and then long-term rehabilitation due to the vulnerability of the brain to a lack of oxygen.

At what stage of pregnancy is the ultrasound scan done?

It is possible to evaluate the effectiveness of uteroplacental blood flow from 16-20 weeks of gestation, when the placenta is normally already completely formed. The examination is included in the screening program in the third trimester of pregnancy - at 30-34 weeks. Sometimes the attending obstetrician-gynecologist recommends to undergo the procedure earlier - simultaneously with the second screening ultrasound scan at 20-24 weeks.

Doppler ultrasound of the fetus

As you know, the first ultrasound is done at 10-14 weeks. At this time, the placenta has not yet finally formed, which means that it is impossible to adequately assess the blood supply. At such an early stage, they study how many embryos have fixed in the uterine cavity, the size of the ovum, the presence of gross malformations and indirect signs of chromosomal abnormalities. For the first time, the expectant mother will be able to hear the heartbeat of the future son or daughter, it appears from about 6 weeks.

Ultrasound of the second trimester is more informative. The fetus has reached sufficient size - you can examine its internal organs, make the necessary measurements, assess the blood supply and the state of the placenta, the amount of amniotic fluid. Some parents are already informed on this ultrasound of the sex of the future baby. The arteries of the umbilical cord are clearly visible - not only their width and blood circulation, but also the location of the loops (the presence of entanglement). The doctor will also roughly determine how much the baby weighs.

The examination is completely painless and looks exactly like a regular ultrasound scan. The doctor will only change the sensor to a Doppler one, apply a special gel to the skin and examine the vessels. At the same time, the mother will hear the sound of the baby's heartbeat. It will take a few minutes for a specialist to decipher the results. If deviations from the norm are found, the doctor recommends the necessary treatment at home, in a day hospital or in the department of pregnancy pathology.

Indications for Doppler ultrasonography for complicated pregnancy:

severe gestosis - increased blood pressure, edema, excess protein in the general urine analysis;

The doctor measures the blood pressure of the pregnant woman

diabetes;
kidney disease;
deviations in the blood coagulation system;
intrauterine growth retardation;
prolongation of pregnancy;
lack or excess of amniotic fluid;
pregnancy with twins or triplets;
Rh-conflict between mother and fetus;
diseases of the cardiovascular system in the mother;
any placental pathology;
complicated course of previous pregnancies;
the only artery of the umbilical cord;
unsatisfactory results of cardiotocography (low heart rate or insufficient motor activity of the fetus).

Is the research safe?

A gynecologist explains to a pregnant woman the need for Doppler ultrasonography

For a long time, ultrasound was considered absolutely safe for mother and child - it does not cause an increase in any diseases or changes in condition, does not even require a puncture of the skin, there is no risk of infection. However, in recent years, publications have appeared that the use of ultrasound causes local heating of tissues, and the use of technology has become more restrained. However, there is no evidence that Doppler sonography is harmful. The need for any intervention, including ultrasound, is always assessed in terms of the balance of benefits and possible harm.

Therefore, you should not go through the procedure just "for the sake of interest" - if necessary, the specialist will definitely prescribe it.

Doppler ultrasonography during pregnancy is a highly informative study, the results of which make it possible to assess the condition of the baby in the womb, predict probable problems during childbirth and childbirth, and also promptly start treatment if necessary.

During pregnancy, the fetus develops and matures continuously. Violation of blood flow can provoke hypoxia in the unborn child due to insufficient supply of oxygen to his body. In the absence of timely therapy, the development of severe fetal defects is possible. Therefore, it is important to assess the state of blood flow in the "fetus-placenta-mother" system in time. Doppler ultrasonography during pregnancy is prescribed to women from the second trimester in case of uninformativeness of other methods. Therefore, you should consider in more detail what an ultrasound scan is during pregnancy.

The Doppler method is based on recording the reflected ultrasonic radiation from moving objects, while the frequency of the waves is determined by the speed and direction of blood flow. The use of special processing of impulses allows you to display a picture on the monitor, by which one can judge the presence of any deviations in the work of the vessels, assess their structure, location.

In a planned mode, the study is carried out at 33-35 weeks of gestation. However, in the presence of indications, the fetal ultrasound is carried out from 16 weeks after the completion of the processes of formation of the placenta. Often, the study is combined with a planned ultrasound scan as part of the second screening at 20-22 weeks.

There are the following types of USG:

Duplex scanning. Allows you to visualize organs and blood vessels, assess the state of blood flow;
Triplex scanning. The study helps to assess blood flow and vascular patency.

UZDG price varies within 1200-3500 rubles, which depends on the city and clinic.

How is USDG performed during pregnancy

Doppler ultrasonography MPPC is a safe procedure for a woman and a fetus, which has no contraindications.

Diagnostics takes no more than 30 minutes, does not cause pain or discomfort, and does not require special training.

The doctor does the decoding of the results of the study immediately after the procedure, so the woman receives the conclusion in her hands on the same day.

Doppler ultrasound is performed in the following order:

A woman needs to lie on the couch, freeing her stomach from clothes;
The doctor applies a little gel to the abdominal area, which prevents the appearance of distortions during the ultrasound scan;
The specialist guides the sensor along the abdomen, assessing the blood flow in large vessels: the uterine and umbilical arteries of the mother, the aorta and cerebral artery of the unborn child. Particular attention is paid to the state of the umbilical cord, microcirculation in the placenta.

What parameters are investigated in the framework of the ultrasonic survey

The study helps the doctor assess and track the state of the circulatory system of the woman and the fetus, as well as the vessels through which nutrients are delivered to the unborn child. During USDG, the following vascular resistance indices (ISR) are assessed:

The ratio of systolic and diastolic pressure (SDO, S / D);
Ripple indices (PI) and resistance (IR).

The parameters obtained are compared with normal values for a certain gestational age.

As part of the USDG, the doctor can determine the following nuances:

Assess the state of the fetal heart by the rhythm, the work of the valves, the structure of the vessels that are adjacent to it;
The blood flow rate of the peripheral circulatory system in the fetus;
The functionality of the woman's circulatory system, heart and kidneys.

The information obtained allows the doctor to draw a conclusion about the state of the vessels, their patency.

What does Doppler ultrasonography detect during pregnancy? How long can this study be carried out?

Doppler ultrasound of the fetus: the main differences from ultrasound

Unlike standard ultrasound diagnostics, the USG procedure involves the use of the Doppler effect, which significantly increases the information content of the method. The study allows you to determine the state of blood flow and blood vessels, to conclude whether the fetus has enough nutrients.

The use of a Doppler transducer will help to identify not only existing pathologies, but also to notice minor vascular lesions, to assess the intensity of blood flow. If you do a routine ultrasound, the doctor will be able to assess only the position of the fetus, the features of its development.

How to decipher the results of ultrasound scan in pregnant women

During the interpretation of the results obtained, the doctor compares the obtained ASC values with the tabular norms according to the gestational period. During pregnancy, the uterus and placenta communicate through terminal villi, which contain a large number of vessels. These formations carry out the delivery of oxygen, nutrients and the removal of waste products.

With an insufficient number of villi, it develops placental insufficiency... As a result, the value of IR and LMS will be high. As a consequence disorders of uteroplacental blood flow there is also an increase in the ASC of the uterine arteries. The IR rate is 0.62-0.82, depending on the period, and the LMS should vary within 2.19-4.67.

Of great importance during intrauterine development is the nature of the blood flow in the uterine arteries. The LMS value is considered normal in the range of 1.66-2.10, PI - 0.40-0.65, IR - 0.3-0.9. A decrease in the blood flow velocity leads to an excess of the normative values of LMS and IR. If there is a pronounced violation of blood flow, then the development of the fetus stops. As a result, the importance of LMS and IR of the carotid and cerebral arteries of the unborn child increases.

Indications for performing ultrasound examination

The following indications are distinguished for an unscheduled ultrasonic survey:

The development of placental insufficiency due to reduced blood flow in pathologies of the placenta;
The umbilical cord entanglement of the fetal neck, which was diagnosed as part of a conventional ultrasound;
Retardation of the fetus in development;
Multiple pregnancy, which provokes an increased load on the uterus and placenta;
The development of preeclampsia in a pregnant woman;
A history of complicated pregnancies or childbirth;
The development of Rh-conflict, when antibodies to the blood cells of the fetus are formed in the woman's body;
Suspicion of a frozen pregnancy - lack of fetal movement;
Premature maturation of the placenta;
History of miscarriages or stillbirth;
Somatic pathologies in a woman that can have a negative effect on blood vessels (diabetes mellitus, hypertension, chronic kidney pathologies, blood clotting disorders);
Lots or low water;
Abnormalities in the development of the heart or brain in the fetus;
Autoimmune diseases (vasculitis or lupus);
Various abdominal injuries.

Doppler ultrasound during pregnancy is a highly informative diagnostic method that allows you to assess the state of the circulatory system of the fetus and woman. The procedure does not require additional preparation, does not cause discomfort in a woman. Experts recommend taking only napkins with you to thoroughly dry your stomach after the examination.

The main indications for USDG during pregnancy