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Doppler flow velocity waveform analysis in high risk pregnancies: a randomized controlled trial
J P Newnham1, M R O'Dea, K P Reid
1University Department of Obstetrics and Gynaecology, King Edward Memorial Hospital for Women, Perth, Western Australia.
British Journal of Obstetrics and Gynaecology
|October 1, 1991
Summary
Doppler waveform analysis in late pregnancy did not reduce neonatal hospital stays. While it slightly altered obstetric management, it did not improve neonatal outcomes and was associated with more depressed Apgar scores.
Area of Science:
- Perinatal Medicine
- Diagnostic Ultrasound
- Maternal-Fetal Medicine
Background:
- Fetal well-being assessment is crucial in high-risk pregnancies.
- Doppler waveform analysis offers insights into fetal circulation.
- Evaluating its impact on neonatal outcomes and obstetric care is essential.
Purpose of the Study:
- To determine if Doppler waveform analysis improves neonatal outcomes.
- To assess the effect of Doppler studies on obstetric management in high-risk pregnancies.
Main Methods:
- Randomized controlled trial involving 505 women with third-trimester pregnancy abnormalities.
- Continuous wave Doppler studies of umbilical and uteroplacental circulations.
- Assessed neonatal length of stay, fetal monitoring, obstetric interventions, and neonatal condition at birth.
Main Results:
- No significant difference in neonatal hospital stay duration.
- Minor shifts in obstetric management, including fewer contraction stress tests.
- Increased likelihood of fetal distress post-labor induction and more frequent depressed Apgar scores in the Doppler group.
Conclusions:
- Doppler waveform studies did not reduce neonatal morbidity.
- A modest impact on obstetric management was observed.
- The utility of Doppler studies depends on existing clinical practices for fetal welfare assessment.