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Doppler ultrasound in multiple pregnancies
1University of Newcastle, Faculty of Medicine and Health Sciences, John Hunter Hospital, Division of Obstetrics and Gynaecology, Newcastle, NSW, Australia.
Bailliere'S Clinical Obstetrics and Gynaecology
|February 4, 1999
Summary
Doppler ultrasound aids in managing multiple pregnancies, particularly twin pregnancies complicated by fetal growth restriction (FGR) and twin-twin transfusion syndrome (TTTS). While promising, further research is needed to confirm its impact on reducing perinatal mortality.
Area of Science:
- Medical imaging
- Maternal-fetal medicine
- Perinatology
Background:
- Multiple pregnancies present unique management challenges.
- Doppler ultrasound has emerged as a key tool in assessing fetal well-being.
- Specific complications like FGR and TTTS require precise diagnostic methods.
Purpose of the Study:
- To review the current applications of Doppler ultrasound in managing multiple pregnancies.
- To evaluate its role in specific conditions such as FGR and TTTS.
- To assess the evidence for Doppler ultrasound in reducing perinatal mortality in twin gestations.
Main Methods:
- Systematic review of OVID and Medline databases.
- Assessment of randomized controlled trials using Cochrane Review Manager.
- Focused review on fetal growth restriction (FGR), twin reversed arterial perfusion sequence, and twin-twin transfusion syndrome (TTTS).
Main Results:
- Historical trials suggest Doppler ultrasound may reduce perinatal mortality in twin pregnancies.
- Doppler ultrasonography can identify intertwin discordancy in cases of FGR due to placental dysfunction.
- In TTTS, discordant fetal size may be present with concordant Doppler findings.
Conclusions:
- Doppler ultrasound is valuable in managing twin pregnancies.
- It assists in differentiating between FGR and TTTS.
- Further randomized controlled trials are recommended to strengthen evidence on mortality reduction.