What doppler shows. In what cases is a doppler assigned without fail. Maria: “It’s better to do it and not worry that something is wrong”
The Doppler effect in the case of a medical study is that ultrasonic waves are reflected from blood particles, and this change will directly depend on the blood flow velocity. Ultrasound with a special sensor is used to assess blood flow through the main vessels (arteries, veins) of the neck, arms, legs. The study can reveal difficulties in blood flow during vasoconstriction, detect blood clots in the veins.
To assess blood circulation in the vessels of the brain, this study is used in the following cases: to determine the risk of stroke, cerebrovascular accident, vasospasm, after coronary artery bypass grafting (to determine the likelihood of embolism), as well as in neurosurgical patients. Indications for Doppler ultrasound are: migraines, dizziness, vegetative-vascular dystonia, headaches of unknown origin.
Doppler of the vessels of the neck reveals the pathology of the vertebral and carotid arteries. This study is used for the following symptoms: noise in the head, transient ischemic attacks with temporary paralysis of half of the body or arm, dizziness, temporary blindness in one eye, flickering before the eyes, short-term loss of consciousness, headaches, temporary imbalance, falls, not accompanied by loss consciousness.
Ultrasound examination of the vessels of the lower extremities reveals the pathology of the arteries and veins. It is performed with the following symptoms and diseases: pathology of the arteries and veins of the lower extremities, intermittent claudication, hypersensitivity of the legs to cold, chilliness, numbness in the feet, varicose veins, swelling of the legs, heaviness in the legs, pigmentation of the skin on the legs.
Doppler ultrasound during pregnancy
Doppler ultrasound is prescribed during pregnancy to determine the rate of fetal blood flow in order to assess the functioning of the placenta. This study is carried out if there are concerns about the intrauterine growth of the child, as well as with an increase in blood pressure in a woman. A cardiotocograph (a special type of Doppler) is used to evaluate the fetal heartbeat. If a pregnant woman regularly feels the movements of the baby, most likely this study will not be prescribed.
The fetus is connected to the placenta through the umbilical cord, 2 arteries and 1 vein pass through it. The placenta delivers nutrients and oxygen to the baby through the blood. If blood flow is obstructed, the fetus may not get enough of them, which can cause growth retardation. In case of detection of high resistance to blood flow through the vessels, the question of early delivery may arise.
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);
- the 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.
Doppler ultrasound during pregnancy is a modern diagnostic method using ultrasound, which allows you to objectively and fully examine the blood circulation of the fetus, placenta and uterus. According to the state of the circulatory system, it is possible to assess the condition of the fetus, the rate of its development - whether the baby suffers from a lack of oxygen, as well as possible pathological changes. Dopplerometry of the fetus is the only technique that can show the exact location of vascular pathology (in the uterus, umbilical cord or placenta).
Doctor's consultation based on the results of tests or ultrasound - 500 rubles. (at the request of the patient)
Why and when to conduct dopplerometry during pregnancy
Today, vascular disease is one of the most common problems in medical practice. Timely diagnosis makes it possible to identify such pathologies at an early stage of development, and at the same time, many factors that can cause the development of circulatory disorders.
The value of the procedure lies in its high information content, thanks to which the doctor is able to identify not only the already developed pathology, but also almost imperceptible preclinical symptoms of the disease. The procedure is prescribed after the complete formation of the placenta - not earlier than 18 weeks, more often at 32-34 weeks as a routine check.
If there is even a slight suspicion of fetal developmental disorders, Doppler ultrasound is performed at any time. Doppler is done in combination with , while the sensations for a pregnant woman, the procedure is no different from the classic ultrasound examination.
The essence of the method
This method of studying the circulatory system is based on the application of the Doppler effect.
For examination, the same ultrasound is used as in an ordinary ultrasound examination. The difference lies in a special sensor based on the Doppler effect and the interpretation of the received data. In the study, ultrasonic waves are recorded, reflected not from static tissues, but from moving objects - blood cells, as a result of which the frequency of the reflected rays varies greatly in comparison with those under study. The device processes the received data and creates a two-dimensional color image. Thanks to this, it is possible to assess the speed and direction of blood flow, the anatomy and patency of blood vessels.
The duration of Doppler ultrasound is 20-40 minutes. It has no contraindications, no complications, no negative effects on the body. The study is completely painless and safe.
Indications
Gynecologists recommend undergoing a Doppler examination 1-2 times during pregnancy, along with . If there are problems, a fetal doppler should be done as soon as possible. Basically, dopplerometry is prescribed when the size of the fetus does not match the gestational age. The procedure is also carried out in the following cases:
- complications in bearing a child;
- fetoplacental insufficiency;
- the mother has chronic and severe diseases (diabetes mellitus, hypertension, anemia, systemic diseases);
- Rhesus conflict between a pregnant woman and a child;
- multiple pregnancy;
- non-immune dropsy of the fetus;
- incorrect position of the fetus in the uterus;
- premature maturation of the placenta;
- entanglement of the child's neck with the umbilical cord, suspicion of hypoxia;
- pronounced oligohydramnios / polyhydramnios;
- preeclampsia (late toxicosis, accompanied by a deterioration in the functioning of the kidneys, blood vessels and brain - protein appears in the urine, pressure rises);
- injury belly in a pregnant woman;
- chromosomal abnormalities of the infant;
- the fetus moves less than usual or no movement is felt at all;
- unsatisfactory results of cardiotocography;
- complications in carrying a previous pregnancy (premature birth, miscarriage, etc.).
Also, a fetal ultrasound with Doppler should be done in cases where the mother is not 20 years old or she is over 35 years old.
What does fetal dopplerometry reveal?
Doppler helps to detect fetal hypoxia in a timely manner and avoid the problem even before the child is in danger, or minimize negative consequences. With its help, the doctor can find out the reasons for the entanglement of the umbilical cord and see how many times and how tightly the baby's neck is wrapped around. Without this vital information, specialists will not be able to choose the right tactics for childbirth, which endangers the health and life of the child.
Also with the help of Doppler you can see:
- the state and rhythm of the fetal heart at rest and movement;
- the condition of the heart valves of the main blood vessels, arteries and veins;
- speed and volume of blood flow of the peripheral circulatory system;
- blood circulation in the umbilical cord and placenta;
- condition of the circulatory system, heart and kidneys of a pregnant woman.
The information obtained allows the doctor to evaluate:
- patency and condition of the vascular bed, the presence of deviations that block the blood flow of the fetus;
- saturation with blood and nutrients of all tissues of the child;
- patency and condition of the umbilical cord, entanglement of the baby's neck;
- efficiency of the placenta;
- the state and work of the circulatory system of a woman during pregnancy.
Preparation and features of fetal ultrasound with Doppler
The procedure does not require any preparatory measures: neither the diet nor the fullness of the bladder and stomach affect the results of the examination. The only recommendation is to take a break from eating for a couple of hours before the examination.
A pregnant woman needs to take the following with her: the direction and results of past tests and examinations (ultrasound, CTG, ECG), an exchange card for a pregnant woman. Paper napkins and a disposable diaper or towel are not needed - everything is provided free of charge in our clinic.
The Doppler ultrasound technique is similar to transabdominal ultrasound. The woman lies on the couch with her back and exposes her stomach. The doctor applies a special gel to the area under study to improve the permeability of ultrasonic waves and then moves the sensor over it, simultaneously examining the data obtained on the monitor. An interpretation of the results is issued to the woman on the same day.
Doplerometry during pregnancy can be performed in several ways:
- Doppler ultrasound is used to assess the direction, intensity, nature of blood flow in the vessels.
- Duplex study - differs from the previous method in greater accuracy and information content. It is used to assess the blood flow of blood vessels and their anatomy.
- Color mapping - the state of even the smallest vessels and their patency is coded by color.
Interpretation of the results of fetal dopplerometry
Assessment of the state of blood supply using Doppler is formed on the basis of the following indicators:
- The systolic-diastolic ratio is the ratio of the maximum and minimum blood flow velocity;
- Index resistance - the ratio of the difference between the maximum and minimum blood flow velocity to the maximum during the period of compression;
- Pulsating index - the ratio of the difference between the maximum and minimum blood flow velocity to the average velocity for a complete heart cycle.
Fetal Doppler: weekly norm and prognosis for deviations
In order for the results to be deciphered correctly and all deviations to be identified, it is necessary to compare the data obtained with the standard values, taking into account the gestational age.
Indicators of the norm of the index of resistance of the uterine arteries
Gestational period (weeks) | The average index of IR of the uterine arteries | Possible fluctuation range |
0,52 | 0,37 – 0,7 |
|
0,51 | 0,36 – 0,69 |
|
0,36 – 0,68 |
||
0,36 – 0,68 |
||
0,35 – 0,67 |
||
0,49 | 0,35 – 0,66 |
|
0,49 | 0,35 – 0,65 |
|
0,48 | 0,34 – 0,64 |
|
0,48 | 0,34 – 0,64 |
|
0,47 | 0,34 – 0,63 |
|
0,46 | 0,34 – 0,62 |
|
0,46 | 0,34 – 0,61 |
|
0,45 | 0,34 – 0,61 |
|
0,45 | 0,34 – 0,59 |
|
0,45 | 0,34 – 0,59 |
|
0,45 | 0,33 – 0,58 |
|
0,44 | 0,33 – 0,58 |
|
0,44 | 0,33 – 0,57 |
|
0,44 | 0,33 – 0,57 |
|
0,43 | 0,33 – 0,57 |
|
0,43 | 0,32 – 0,57 |
|
0,43 | 0,32 – 0,56 |
Normative indicators of the pulsation index of the uterine arteries
Gestational period (weeks) | Average PI of uterine arteries | Possible fluctuation range |
1,54 | 1,04 – 2,03 |
|
1,47 | 0,98 – 1,96 |
|
1,41 | 0,92 – 1,9 |
|
1,35 | 0,86 – 1,85 |
|
0,81 – 1,79 |
||
1,25 | 0,76 – 1,74 |
|
0,71 – 1,69 |
||
1,16 | 0,67 – 1,65 |
|
1,12 | 0,63 – 1,61 |
|
1,08 | 0,59 – 1,57 |
|
1,05 | 0,56 – 1,54 |
|
1,02 | 0,53 – 1,51 |
|
0,99 | 0,5 – 1,48 |
|
0,97 | 0,48 – 1,46 |
|
0,95 | 0,46 – 1,44 |
|
0,94 | 0,44 – 1,43 |
|
0,92 | 0,43 – 1,42 |
|
0,92 | 0,42 – 1,41 |
|
0,91 | 0,42 – 1,4 |
|
0,91 | 0,42 – 1,4 |
|
0,91 | 0,42 – 1,4 |
|
0,92 | 0,42 – 1,41 |
Indicators of the right and left uterine artery may be different. The main thing is that both indicators do not go beyond the limits of the norm. If both indicators do not correspond to the norm, this indicates a violation of the uteroplacental circulation. If one indicator is for asymmetry of uteroplacental blood flow
It is important to note that at 18-21 weeks there may be deviations in indicators due to the incomplete adaptive physiological process of cytotrophoblast invasion. In this case, fetal Doppler should be repeated after 2-3 weeks.
Normative indicators of the systolic-diastolic ratio in the fallopian tubes
Doppler norm: umbilical arteries
Normative values of the index of resistance of the umbilical arteries:
Gestational period (weeks) | The average index of IR of the umbilical arteries | Possible fluctuation range |
0,74 | 0,63 – 0,84 |
|
0,73 | 0,62 – 0,83 |
|
0,72 | 0,61 – 0,82 |
|
0,71 | 0,6 – 0,82 |
|
0,59 – 0,81 |
||
0,69 | 0,58 – 0,8 |
|
0,68 | 0,58 – 0,79 |
|
0,67 | 0,57 – 0,79 |
|
0,66 | 0,56 – 0,78 |
|
0,65 | 0,55 – 0,78 |
|
0,64 | 0,54 – 0,77 |
|
0,63 | 0,53 – 0,76 |
|
0,62 | 0,52 – 0,75 |
|
0,61 | 0,51 – 0,74 |
|
0,49 – 0,73 |
||
0,59 | 0,48 – 0,72 |
|
0,58 | 0,46 – 0,71 |
|
0,57 | 0,44 – 0,7 |
|
0,56 | 0,43 – 0,69 |
|
0,55 | 0,42 – 0,68 |
|
0,54 | 0,41 – 0,67 |
|
0,53 | 0,4 – 0,66 |
Normative values of the pulsation index of the umbilical cord arteries:
Gestational period (weeks) | Average PI of umbilical cord arteries | Possible fluctuation range |
1,72 | 1,53 – 1,9 |
|
1,62 | 1,45 – 1,78 |
|
1,45 | 1,25 – 1,65 |
|
1,35 | 1,18 – 1,51 |
|
1,35 | 1,17 – 1,52 |
|
1,25 | 1,09 – 1,41 |
|
1,12 | 0,96 – 1,27 |
|
1,15 | 0,98 – 1,33 |
|
1,01 | 0,86 – 1,16 |
|
1,01 | 0,86 – 1,16 |
|
1,05 | 0,87 – 1,23 |
|
1,03 | 0,88 – 1,17 |
|
0,95 | 0,76 – 1,13 |
|
0,85 | 0,71 – 0,99 |
|
0,84 | 0,67 – 1,1 |
|
0,84 | 0,59 – 0,93 |
|
0,83 | 0,58 – 0,99 |
|
35 – 37 | 0,81 | 0,57 – 1,05 |
38 – 41 | 0,74 | 0,37 – 1,08 |
Obtaining zero and reverse values of diastolic blood flow is considered a pathology. This indicates a critical condition of the fetus, the death of which will occur in 2-3 days. In this case, a cesarean section is immediately prescribed (if the gestational age is more than 28 weeks) to save the baby's life.
Normative values of the systolic-diastolic ratio of the umbilical arteries:
Violation of blood flow in the umbilical cord entails a delay in the development of the child.
Doppler ultrasound norms: fetal middle cerebral artery
Gestational period (weeks) | Average PI in the middle cerebral artery | Possible fluctuation range |
1,83 | 1,36 – 2,31 |
|
1,87 | 1,4 – 2,34 |
|
1,91 | 1,44 – 2,37 |
|
1,93 | 1,47 – 2,4 |
|
1,96 | 1,49 – 2,42 |
|
1,97 | 1,51 – 2,44 |
|
1,98 | 1,52 – 2,45 |
|
1,99 | 1,53 – 2,45 |
|
1,99 | 1,53 – 2,46 |
|
1,99 | 1,53 – 2,45 |
|
1,98 | 1,52 – 2,44 |
|
1,97 | 1,51 – 2,43 |
|
1,95 | 1,49 – 2,41 |
|
1,93 | 1,46 – 2,39 |
|
1,43 – 2,36 |
||
1,86 | 1,4 – 2,32 |
|
1,82 | 1,36 – 2,28 |
|
1,78 | 1,32 – 2,24 |
|
1,73 | 1,27 – 2,19 |
|
1,67 | 1,21 – 2,14 |
|
1,61 | 1,15 – 2,08 |
|
1,55 | 1,08 – 2,01 |
Maximum velocity in the fetal middle cerebral artery:
Gestational period (weeks) | Average | Possible fluctuation range |
19,7 | 16,7 – 23 |
|
21,8 | 18,1 – 26 |
|
23,9 | 19,5 – 29 |
|
20,8 – 32 |
||
28,2 | 22,2 – 35 |
|
30,3 | 23,6 – 38,1 |
|
32,4 | 24,9 – 41,1 |
|
34,6 | 26,3 – 44,1 |
|
36,7 | 27,7 – 47,1 |
|
38,8 | 29 – 50,1 |
|
40,9 | 30,4 – 53,1 |
|
43,1 | 31,8 – 56,1 |
|
45,2 | 33,1 – 59,1 |
|
47,3 | 34,5 – 62,1 |
|
49,5 | 35,9 – 65,1 |
|
51,6 | 37,2 – 68,2 |
|
53,7 | 38,6 – 71,2 |
|
55,8 | 40 – 74,2 |
|
41,3 – 77,2 |
||
60,1 | 42,7 – 80,2 |
|
62,2 | 44,1 – 83,2 |
|
64,4 | 45,4 – 86,2 |
Normative values of the systolic-diastolic ratio in the middle cerebral artery:
Normal fetal doppler readings: fetal aorta
Violations in the blood circulation of the fetal aorta can be detected only after 22-24 weeks of pregnancy.
Normative value of the pulsation index of the fetal aorta:
Gestational period (weeks) | Mean PI of the fetal aorta | Possible fluctuation range |
1,79 | 1,49 – 2,16 |
|
1,79 | 1,49 – 2,16 |
|
1,79 | 1,49 – 2,17 |
|
1,49 – 2,18 |
||
1,49 – 2,19 |
||
1,81 | 1,49 – 2,2 |
|
1,81 | 1,49 – 2,21 |
|
1,82 | 1,5 – 2,22 |
|
1,83 | 1,5 – 2,24 |
|
1,82 | 1,51 – 2,25 |
|
1,81 | 1,51 – 2,26 |
|
1,81 | 1,52 – 2,28 |
|
1,53 – 2,29 |
||
1,53 – 2,31 |
||
1,79 | 1,54 – 2,32 |
|
1,79 | 1,55 – 2,34 |
|
1,79 | 1,55 – 2,35 |
|
1,92 | 1,56 – 2,36 |
|
1,93 | 1,57 – 2,38 |
|
1,94 | 1,57 – 2,39 |
|
1,94 | 1,57 – 2,4 |
|
1,95 | 1,58 – 2,41 |
Normative values of the resistance index of the fetal aorta:
Normative values of the systolic velocity of the fetal aorta:
Gestational period (weeks) | Average systolic rate | Possible fluctuation range |
26,88 | 12,27 – 44,11 |
|
28,87 | 14,1 – 46,28 |
|
30,52 | 15,6 – 48,12 |
|
31,95 | 16,87 – 49,74 |
|
33,23 | 18 – 51, 2 |
|
34,39 | 19 – 52,55 |
|
35,47 | 19,92 – 53,81 |
|
36,47 | 20,77 – 55,01 |
|
37,42 | 21,55 – 56,13 |
|
38,32 | 22,3 – 57,22 |
|
39,17 | 23,02 – 58,26 |
|
40,01 | 23,66 – 59,27 |
|
40,8 | 24,3 – 60,26 |
|
41,57 | 24,92 – 61,21 |
|
42,32 | 25,52 – 62,16 |
|
43,06 | 26,1 – 63,08 |
|
43,79 | 26,67 – 64,02 |
|
44,52 | 27,24 – 64,93 |
|
45,24 | 27,8 – 65,81 |
|
45,96 | 28,37 – 66,72 |
|
46,7 | 28,95 – 67,65 |
|
47,47 | 29,57 – 68,62 |
Normative values of the systolic-diastolic ratio of the fetal aorta:
Doppler norms during pregnancy: venous duct
The venous duct is not evaluated using indexes. An indicator of pathology is zero or negative blood flow values. Typically, these values are obtained with fetal malnutrition, congenital heart disease, non-immune dropsy.
In the case when the blood circulation in the umbilical cord is in a critical state, but no deviations in the blood flow were detected in the venous duct, it is possible to extend the gestation to the optimal time for delivery.
How will the gynecologist understand if there is fetal hypoxia?
The doctor compares the normal Doppler readings with the result.
- An increase in IR and LMS in the uterine arteries is a sign that the baby is not receiving enough oxygen. This will delay development.
- An increase in Doppler for the umbilical artery is a sign of feto-placental insufficiency. This is a vascular pathology, so the fetus is already suffering. It is also a sign of gestosis.
- If the indicators of IR and LMS in the umbilical cords with multiple pregnancy differ, this indicates that one of the babies is experiencing hypoxia (transfusion syndrome).
- An excess of LMS and IR in the aorta is a symptom of a child’s poor health due to a prolonged pregnancy, due to diabetes in a pregnant woman, with a conflict over the Rh factor, etc.
- A decrease in LMS and IR with dopplerometry in the carotid and cerebral arteries is observed in an extremely difficult condition of the fetus, since in this case only the main organs that support life are supplied with blood. In such a situation, an artificial birth should be carried out immediately.
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 apparatus. 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 in early pregnancy are, for example, a suspicion of a delay in the intrauterine formation of systems and organs of the child, phytoplacental insufficiency. Early dates 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 the 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 life.
The use of ultrasound to monitor the course of pregnancy has become as common as a complete blood count or blood pressure measurement.
Almost all young mothers know the principle of this research technique and completely trust it. In some cases, in addition to the usual ultrasound, the attending doctor directs the pregnant woman for an additional examination with dopplerography. What is such a diagnosis used for and is it worth worrying if there are indications for its implementation?
Doppler ultrasound during pregnancy: what is it
With a conventional ultrasound, the doctor observes the tissues of the mother and baby, visible due to the uneven reflection of ultrasound radiation. Doppler works a little differently: when the function is turned on, an image of blood components moving through the vessels of the mother and fetus, as well as in the umbilical cord and placenta, appears on the screen.
Traditional ultrasound provides information about the location and anatomical features of organs and vessels, while Doppler sonography provides information about the dynamics of blood flow in the vascular system.
Why is a doppler prescribed during pregnancy
Many expectant mothers are sent for a planned ultrasound scan several times, and for dopplerography - never for the entire period of pregnancy. Having received a referral for additional research, a woman may suspect that something is wrong with her baby. Indications for Doppler ultrasound can be:
1
Disorders of the cardiovascular system mother or fetus, which can lead to deviations in the development of the baby due to its insufficient supply of nutrients and oxygen; 
2 Factors that complicate the course of pregnancy: the presence of more than one fetus, oligohydramnios, late toxicosis, general and systemic diseases of the mother,.
Interesting! Placental abruption: symptoms, treatment and prevention
3 Mismatch between body size and fetal development parameters the established gestational age, which may be the result of hypoxia (oxygen starvation);
4 Pathological changes in the position, structure and functioning of the placenta, in which the metabolism between the organisms of the future mother and baby is difficult;
5 Suspicion of cord entanglement. Sometimes traditional ultrasound does not provide complete information about the position of the umbilical cord, and the Doppler shows the number and location of the loops.
If a woman during pregnancy receives a referral for a Doppler ultrasound, she should not worry: in many cases, during the examination, suspicions of the presence of a pathology are not confirmed.
How doppler ultrasound is performed during pregnancy
This study does not require special preparation: it is carried out as part of the usual. 
The woman is in a prone position, and the doctor, after applying a special gel, begins the examination. After analyzing the image on the monitor, he determines the position of the fetus, its activity, anatomical features, assesses the condition of the placenta and umbilical cord.
Then the Doppler function is turned on, and information about the movement of blood through the vessels is displayed on the screen.
There are two types of dopplerography: duplex and triplex. When using the first, the sonologist examines the structure of the vessel, its patency and the speed of blood flow in it. The doctor can immediately determine the causes of blood flow disorders.
When you turn on the second type of Doppler, you can observe a color dynamic image of blood cells in the vascular system. This provides additional opportunities for examination.
How often can ultrasound be done during pregnancy
On average, a woman visits a sonologist's office three times during pregnancy: in the early stages to establish the fact of pregnancy, at 20-24 weeks for intermediate control over the condition and development of the baby, and at 30-34 weeks to assess the readiness of the mother and baby for the upcoming birth. 
If there are indications for dopplerography, it is combined with a traditional examination. Sometimes the attending physician directs for such a study more often - if necessary, to monitor the dynamics of changes in one or another parameter.
Interesting! Hypoxia of the fetus and in newborns: symptoms, consequences
Practice shows that ultrasound is safe for a pregnant woman and her baby.
For the entire period of its use, doctors have not identified a single pathology associated with the influence of this radiation. On the other hand, ultrasonic beams exert pressure on tissues and cause very little heating. The level of this influence should not go beyond the permissible limits.
According to the results of Doppler ultrasound, the doctor can also adjust the tactics of childbirth.