Biomaterial Database

WITHDRAWN. Doppler ultrasound for fetal assessment in high risk pregnancies. 2010

Zarko Alfirevic, and James P Neilson

School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, UK, L8 7SS.

BACKGROUND Abnormal waveforms from Doppler ultrasound may indicate poor fetal prognosis. It is also possible that Doppler ultrasound could encourage inappropriate early delivery. OBJECTIVE The objective of this review was to assess the effects of Doppler ultrasound in high risk pregnancies on obstetric care and fetal outcomes. METHODS We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: June 2001. METHODS Randomised trials of Doppler ultrasound for the investigation of umbilical artery waveforms in high risk pregnancies compared to no Doppler ultrasound. METHODS Trial quality was assessed and data were extracted by both reviewers. Study authors were contacted for additional information. RESULTS Eleven studies involving nearly 7000 women were included. The trials were generally of good quality. Compared to no Doppler ultrasound, Doppler ultrasound in high risk pregnancy (especially those complicated by hypertension or presumed impaired fetal growth) was associated with a trend to a reduction in perinatal deaths (odds ratio 0.71, 95% confidence interval 0.50 to 1.01). The use of Doppler ultrasound was also associated with fewer inductions of labour (odds ratio 0.83, 95% confidence interval 0.74 to 0.93) and fewer admissions to hospital (odds ratio 0.56, 95% 0.43 to 0.72), without reports of adverse effects. No difference was found for fetal distress in labour (odds ratio 0.81, 95% confidence interval 0.59 to 1.13) or caesarean delivery (odds ratio 0.94, 95% 0.82 to 1.06). CONCLUSIONS The use of Doppler ultrasound in high risk pregnancies appears to improve a number of obstetric care outcomes and appears promising in helping to reducing perinatal deaths.

UI	MeSH Term	Description	Entries
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D001783	Blood Flow Velocity	A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.	Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014469	Umbilical Arteries	Specialized arterial vessels in the umbilical cord. They carry waste and deoxygenated blood from the FETUS to the mother via the PLACENTA. In humans, there are usually two umbilical arteries but sometimes one.	Arteries, Umbilical,Artery, Umbilical,Umbilical Artery
D016032	Randomized Controlled Trials as Topic	Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.	Clinical Trials, Randomized,Controlled Clinical Trials, Randomized,Trials, Randomized Clinical
D016216	Ultrasonography, Prenatal	The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.	Fetal Ultrasonography,Prenatal Diagnosis, Ultrasonic,Ultrasonography, Fetal,Diagnosis, Prenatal Ultrasonic,Diagnosis, Ultrasonic Prenatal,Prenatal Ultrasonic Diagnosis,Prenatal Ultrasonography,Ultrasonic Diagnosis, Prenatal,Ultrasonic Prenatal Diagnosis,Diagnoses, Prenatal Ultrasonic,Diagnoses, Ultrasonic Prenatal,Prenatal Diagnoses, Ultrasonic,Prenatal Ultrasonic Diagnoses,Ultrasonic Diagnoses, Prenatal,Ultrasonic Prenatal Diagnoses
D018566	Pregnancy, High-Risk	Pregnancy in which the mother and/or FETUS are at greater than normal risk of MORBIDITY or MORTALITY. Causes include inadequate PRENATAL CARE, previous obstetrical history (ABORTION, SPONTANEOUS), pre-existing maternal disease, pregnancy-induced disease (GESTATIONAL HYPERTENSION), and MULTIPLE PREGNANCY, as well as advanced maternal age above 35.	High-Risk Pregnancy,High Risk Pregnancy,High-Risk Pregnancies,Pregnancies, High-Risk,Pregnancy, High Risk
D018608	Ultrasonography, Doppler	Ultrasonography applying the Doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. (Stedman, 25th ed)	Doppler Ultrasonography,Doppler Ultrasound,Doppler Ultrasound Imaging,Doppler Ultrasound Imagings,Doppler Ultrasounds,Imaging, Doppler Ultrasound,Imagings, Doppler Ultrasound,Ultrasound Imaging, Doppler,Ultrasound Imagings, Doppler,Ultrasound, Doppler,Ultrasounds, Doppler