[Development of Doppler parameters in fetal and maternal blood vessels 10 days before to 10 days after the calculated due date].
Doppler sonography can help to assess a foetal risk situation prospectively. This procedure is therefore well suited for the screening of risk pregnancies in the 3rd trimenon. The role of Doppler ultrasound at delivery is still controversial, since, on the one hand, no data on the behaviour of Doppler parameters directly at the onset of delivery are available, and on the other hand the obstetric consequences from pathological findings are not clear. For this reason, we observed 45 normal pregnancies from the 10th day prior to the date of confinement till the 10th day post partum. In 20 patients we registered Doppler parameters from 4 days before until the onset of true labour. In all these cases, a reduction of the end-diastolic blood flow in the foetal aorta was found, which became evident by the increase of the resistance index to pathological values. Concomitant decrease of the resistance index in the foetal carotid artery was typical for a circulatory system. Since foetal outcome was normal in all newborn, this change in Doppler parameters directly at the beginning of labour must be considered as physiological. The findings suggest a physiological placental insufficiency. Since however, parameters in the uterine vessels did not show any changes, the insufficiency has its probable origin in the placenta. From these findings, one might speculate, that the supply deficiency is the labour inducing factor. No clinical consequence can thus result from pathological Doppler data found in patients directly prior and after delivery. Cardiotocographic screening is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
Sohn
C
C
Universitätsfrauenklinik Heidelberg.
Stolz
W
W
D000328:Adult; D015148:Cardiotocography; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005333:Fetus / Q000098:blood supply*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000502:physiology*; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000502:physiology*; D011446:Prospective Studies; D012016:Reference Values; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014590:Uterine Contraction / Q000502:physiology; D014599:Uterus / Q000098:blood supply; D014655:Vascular Resistance / Q000502:physiology
Untersuchung zur Entwicklung der Dopplerparameter in fetalen und mütterlichen Gefässen 10 Tage vor bis 10 Tage nach errechnetem Geburtstermin.