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Evidence-based Approach to Umbilical Artery Doppler Fetal Surveillance in High-risk Pregnancies: An Update

MAULIK, DEV MD, PhD; MUNDY, DAVID MD; HEITMANN, ERICA MD; MAULIK, DEVIKA MD

Clinical Obstetrics & Gynecology: December 2010 - Volume 53 - Issue 4 - pp 869-878
doi: 10.1097/GRF.0b013e3181fbb5f5
New Horizons In Doppler Imaging In Obstetrics

Antepartum fetal surveillance with Doppler ultrasound of umbilical artery has shown significant diagnostic efficacy in identifying fetal compromise in pregnancies complicated with fetal growth restriction and preeclampsia. Moreover, randomized clinical trials and their meta-analyses have shown its effectiveness in decreasing perinatal mortality (level I evidence). This is the only antepartum fetal test that has shown this level of effectiveness. There is no evidence that routine Doppler in low-risk pregnancies improves the outcome. It is recommended that umbilical artery Doppler should be the standard of practice in managing high-risk pregnancies complicated with fetal growth restriction and preeclampsia (level A recommendation). However, its use should be integrated with other current fetal monitoring tests (levels B and C recommendation). The overall management should also be guided by additional clinical considerations such as the gestational age, fetal and maternal status, and obstetrical conditions.

UMKC School of Medicine, Kansas City, Missouri

Correspondence: Dev Maulik, MD, PhD, Department of Obstetrics and Gynecology, Women's Health, UMKC School of Medicine, Truman Medical Center, OB/GYN Administration, Kansas City, MO. E-mail: Dev.Maulik@tmcmed.org; devmaulik@yahoo.com

© 2010 Lippincott Williams & Wilkins, Inc.