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Analysis of umbilical artery flow parameters during fetal variable decelerations using computerized Doppler

O Tadmor1, Y Bocker, R Rabinowitz

  • 1Department of Obstetrics and Gynecology, Misgav Ladach Hospital, Jerusalem.

Fetal Diagnosis and Therapy
|March 11, 1999
PubMed
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Doppler ultrasonography reveals two types of fetal heart rate variable decelerations during labor. Some decelerations are preceded by increased umbilical artery resistance, potentially indicating umbilical artery occlusion.

Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Cardiotocography

Background:

  • Fetal heart rate (FHR) monitoring is crucial during labor.
  • Variable decelerations (VD) are common but can indicate fetal distress.
  • Differentiating causes of VD is important for clinical management.

Purpose of the Study:

  • To investigate umbilical artery blood flow changes during FHR variable decelerations.
  • To explore the potential of Doppler ultrasonography in distinguishing VD subtypes.
  • To correlate Doppler findings with potential causes of VD, such as umbilical artery occlusion or fetal hypoxia.

Main Methods:

  • Doppler ultrasonography was used to obtain umbilical artery velocity waves.
  • Measurements were taken before, during, and after 20 episodes of VD in 8 women during labor.

Related Experiment Videos

  • Umbilical artery resistance flow parameters were analyzed.
  • FHR patterns, including accelerations and decelerations, were correlated with Doppler findings.

    • Main Results:

    • Significant increases in umbilical artery resistance were observed during 50% of VD episodes.
    • In 30% of VD, increased resistance preceded the FHR decrease (arterial resistance VD - AR-VD).
    • In 50% of VD, increased resistance did not precede the FHR decrease (venous resistance VD - VR-VD).
    • AR-VD was associated with fewer preceding FHR accelerations compared to VR-VD.

    Conclusions:

    • Doppler ultrasonography can help differentiate between two types of VD.
    • AR-VD may be caused by umbilical artery occlusion, indicated by preceding resistance increases.
    • VR-VD, without preceding resistance increases, may be associated with fetal hypoxia.