Umbilical artery Doppler velocimetry as a labor admission test

Doppler ultrasound of the umbilical artery flow velocity waveform was studied prospectively as an admission test at the labor ward. Recordings were made in 575 women in various stages of labor before, during, and after uterine contractions, and evaluated in relation to intrapartum and fetal outcome variables. No association was found between abnormal flow velocity waveforms and cord complications, meconium-stained amniotic fluid, or abnormal fetal heart rate tracing, nor was there any association with operative delivery for fetal distress or low Apgar scores at 1 and 5 minutes. Small for gestational age fetuses had significantly more abnormal flow velocity waveforms than appropriate for gestational age fetuses, and so had those with umbilical artery acidemia compared with those with normal pH. The results indicate that Doppler recording of the umbilical artery flow velocity waveform as an admission test at the labor ward is not a good predictor of fetal distress in an unselected population.