Doppler ultrasound waveforms in the fetal umbilical artery: quantitative analysis technique

Doppler ultrasound waveforms from the fetal umbilical artery were analyzed by a new quantitative technique. Normal pregnancy and cases of fetal growth failure were considered. Data from the spectrum analyzer were dumped to a microcomputer, the velocity waveforms calculated and a representative waveform obtained by ensemble averaging. This curve was then fitted by a 4-parameter analytic function. We introduce R, the relative flow rate index, which measures the ratio of the average flow rate before the systolic peak to the average rate during the remainder of the cardiac cycle. In cases of fetal growth failure this ratio was significantly greater than in normal pregnancy. Other new quantities defined are the normalized systolic decay time index and the constant flow ratio. The AB ratio was also calculated. Fetal growth failure has been associated with raised placental resistance. We suggest that the fetus can initially compensate for this by increasing cardiac contractility. This can be seen by interpreting the R and AB values together. Our analysis technique enables the waveform to be efficiently described, and provides useful diagnostic information about placental function and fetal wellbeing.