Pulsed Doppler on a vaginal probe. Necessity, convenience, or luxury?

One hundred twenty-seven pregnancies were studied between 5 and 12 weeks of amenorrhea with Doppler ultrasound coupled with a vaginal probe. These biologically proven pregnancies had no clinical sign of abnormality; however, 29 were detected not to be evolving. Doppler signals were obtained from the embryonic heart, umbilical cord, trophoblastic crown, peritrophoblastic area, and from the uterine and ovarian arteries. In normally evolving pregnancies, no intratrophoblastic flow was detected, whereas it was present in all missed abortions. The peritrophoblastic area always generates a Doppler signal with an important diastolic component. The resistance index (RI) of uterine arteries was constant during the first trimester of pregnancy (RI = .77 +/- .15) and a protodiastolic notch was found in 58% of the cases. The combined use of these two modalities of examination was demonstrated. Although the clinical efficacy of the method has not yet been demonstrated, this combination of techniques opens new perspectives to echography and adds a dynamic dimension to morphologic studies.