Modern methods of ultrasound during pregnancy also include the use of Doppler. This study allows you to identify various pathologies of intrauterine development in the fetus at the earliest stages of its growth in the mother's womb. This article will tell expectant mothers about what a Doppler study is and when it is required.

What it is?

The use of Doppler ultrasound (USDG) is quite often used in both obstetrics and gynecology. This is due to the fact that these methods do not cause any dangerous consequences either in the body of the expectant mother or in the baby in her womb.

At its core, Doppler study is based on the study of the speed of the changed wavelength. The principle of operation of the equipment used to conduct such surveys is quite simple. It generates waves of a certain frequency, which penetrate the skin well and reach certain moving objects. Reflected from them, the waves fall back into the sensor. This process is further processed by the device itself.

Such a physical feature of the operation of the devices explains the fact that with the help of Doppler the work of only “movable” organs is evaluated. The blood contains a large number of a wide variety of cells - erythrocytes, platelets, leukocytes. They are in the bloodstream in constant motion. This activity determines the possibility of using Doppler devices for blood tests.

The main area of ​​application of this test is assessment of uteroplacental blood flow. It should be noted that doctors use dopplerometry to establish various disorders associated with the blood supply to internal organs. The use of this research method during pregnancy makes it possible to identify various pathologies that occur both in the placenta and in the blood vessels of the uterus that feed the fetus.

Such types of examinations are carried out by doctors who have certificates both in ultrasound diagnostics and in performing ultrasound. It is very important that only experienced and qualified specialists work with expectant mothers. This is especially necessary in cases where a pregnant woman has any pathologies of the course of pregnancy.

From the side of dopplerometry, it is very similar to conventional ultrasound. The examination is also carried out using a special apparatus. During pregnancy, several such studies may be carried out. The frequency and necessity of their implementation is determined by the attending gynecologist.

The first studies were carried out strictly in M-mode. This method did not allow doctors to obtain all the necessary information about the presence of various pathologies in the body of the expectant mother.

Technological progress has contributed to the fact that such tests have been replaced by more modern methods. These include echocardiography (ECHO - KG), as well as color mapping. These studies are most successfully used to detect various heart defects in the fetus and are usually performed in the 3rd trimester of pregnancy.

When is it held?

Many researchers believe that frequent dopplerography of uterine blood flow is very harmful to the unborn fetus. Therefore, in women whose pregnancy proceeds without any significant deviations, this study, as a rule, is not carried out.

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Dopplerography may already be prescribed from 20 weeks of pregnancy. This is due to the fact that by this time the fetus already has signs of active blood supply and the heart is working. There are strict medical indications for Doppler ultrasound at this stage of pregnancy. The need for such a study is determined by the obstetrician-gynecologist observing the future mother.

In most cases, ultrasound methods are used much later. They are usually applied at 30-34 weeks of gestation. Such a study is not carried out for all expectant mothers, but only if they have strict medical indications. Often, dopplerography in the third trimester of pregnancy is combined with ultrasound. This combination of methods allows you to track the current state of the fetus at a certain stage of its intrauterine development.

Doppler sonography- this is one of the latest research, which has become actively used in obstetrics in recent years. It allows you to identify various disorders in the work of the cardiovascular system in the unborn child at the stage of its intrauterine development. Competent specialists, conducting such a study, can identify a variety of disorders in the work of a small fetal heart.

The qualitative conduct of this test also allows you to identify future congenital heart defects.

Modern equipment used to conduct such studies allows ultrasound doctors to obtain truly unique information. So, doctors can determine the blood flow in most of the vital blood vessels of the fetus. They assess the adequacy of the blood supply by assessing the movement of blood particles along the middle cerebral artery, umbilical cord and aorta of the unborn baby.

More experienced professionals with extensive clinical experience in performing Doppler ultrasound can also evaluate the blood flow in some of the vital blood vessels that feed the internal organs of the fetus. Such a study makes it possible to detect various anatomical defects at the earliest possible stages of their formation. In some cases, the development of certain anomalies can be prevented during fetal development.

With the help of ultrasound, various indicators are very clearly traced both arterial and venous circulation. To do this, doctors use special tables that contain all the necessary norm values. In each stage of pregnancy, these indicators will be different. With the use of such medical documents, ultrasound diagnostics doctors can draw up a correct conclusion about the result of the study.

The use of various modes allows not only to evaluate the immediate internal structure of blood vessels, but also to study the speed of movement of blood particles during blood flow.

Switching to another mode allows you to get even a color three-dimensional image. Such a three-dimensional image gives doctors a more complete picture of the disorders in the fetus.

For mothers who are carrying several babies at once, dopplerography is performed quite often. The use of this method makes it possible to detect blood flow disorders in each of the twins. Dopplerography can also be used to establish indirect signs of strong compression or clamping of the umbilical blood vessels.

If the expectant mother suffers from diabetes or has concomitant diseases of the cardiovascular system, then Doppler ultrasound is performed for her for medical reasons. In diseases of the kidneys and urinary tract, this study is also an essential condition for diagnosis.

The pathological course of pregnancy, which occurs against the background of preeclampsia, is the reason leading to an ultrasound scan for a pregnant woman. Performing such a study in this condition allows timely detect any deviations, which can even lead to miscarriage or death of the fetus in the mother's womb.

With the help of Dopplerography, a variety of disorders that have arisen in the fetal membranes can be assessed. Various anomalies in the structure of the umbilical cord are also perfectly detected using dopplerography. Fetal growth retardation syndrome is another significant medical indication for which ultrasound is performed. This test allows you to accurately identify this serious pathology.

If a mother and her future baby have a different Rh factor, then this can cause the development of many pathological disorders both in the body of a woman and in her future baby. This condition is quite dangerous. In some cases, the Rh conflict can cause spontaneous miscarriages. To identify various violations in this case, Dopplerography is performed.

The entanglement of the umbilical cord of the fetus is an urgent indication for a Doppler study. In this case, the sooner the examination is carried out, the greater the chances for a favorable resolution of this situation. The appearance of sudden bloody discharge from the genital tract, especially in the later stages of bearing a baby, becomes a strong medical indication for this study.

In some cases, ultrasound can be performed for expectant mothers who are carrying babies after 35 years. Doctors believe that by this age the number of possible pathologies during pregnancy increases significantly.

To identify the very first signs of various, even the most minimal pathologies of the uteroplacental blood flow, dopplerometry is performed.

How to properly prepare for research?

Many pregnant women begin to worry a few days before the study. Doing this is not worth it. Dopplerography is an absolutely painless examination that does not bring any pain and discomfort.

If it will be carried out in a clinic, then the expectant mother should take sheet or towel. They will be needed in order to lay them on the couch before the procedure. Currently, pharmacies sell special disposable products. In some cases, using them is much more convenient than carrying a towel from home.

In private clinics, all disposable sheets and napkins are provided free of charge. All this is already included in the established cost of the procedure. If the study is carried out in a regular clinic, then you should also take a few more paper napkins with you. She may need them in order to remove the remnants of a special gel that will be used to treat the stomach before the procedure.

Some kind of strict diet before the study is usually not required. However, before the analysis should not be abused vegetables and fruits. Such products contain quite a lot of coarse fibrous fiber, which can increase gas formation. A swollen stomach from gases will make it difficult for the doctor to visualize (examine) the internal organs.

Methodology

It is also not worth eating and drinking a lot of water immediately before the study. This may contribute to the fact that the doctor simply will not see anything when performing dopplerometry. Also, overeating and drinking too much liquid can cause a pregnant woman to experience nausea or even vomiting when lying down.

For the study, you should choose the most comfortable clothing. The doctor's office for ultrasound diagnostics is not a fashionable podium. Clothing should not restrict movement. You should choose quite warm and at the same time comfortable things.

Clothing that can be easily removed, exposing the stomach for the study, is also suitable.

This study is carried out in the doctor's office ultrasound diagnostics. Coming to such an appointment, a pregnant woman knows the exact time at which it will be held. The duration of this procedure depends on many different factors. Experienced specialists perform dopplerography usually in 20-30 minutes. However, in the pathological course of pregnancy, the time of the study can be significantly lengthened.

The expectant mother is placed on a special couch before the examination. The standard position is on the back. Only in some cases, the doctor may ask the pregnant woman to turn to the left side. Usually this situation is possible in the third trimester of pregnancy. In the position on the left half of the body, the pressure of the uterus, in which the baby is already quite large in size, on the inferior vena cava is significantly reduced.

After preparation, the doctor takes a special sensor. With it, he will conduct research. The sensor touches the skin, and various images appear on the screen of the device.

Before conducting the main research procedure, the specialist must establish the main anatomical landmarks. These include: the main arteries of the uterus and their branches, as well as the blood vessels of the umbilical cord. They are very important for determining the main indicators of uteroplacental blood flow.

Then, for better visualization, the doctor applies a special gel to the woman's abdomen. The composition of this gel is as safe and hypoallergenic as possible. These drugs undergo multi-stage testing before being approved for use in pregnant women. The structure of this gel is usually sticky, color and smell are completely absent.

To assess Dopplerography, the most important are not the absolute values ​​of the fetal-uterine blood flow, but their qualitative indicators. Their ratios are also subject to interpretation. To obtain such values, various indicators are measured at different periods of the cardiac cycle - during systolic and diastolic contractions.

As a result of measuring such indicators, doctors receive systole-diastolic ratios, pulsation indices, resistance indices, as well as the average blood flow velocity. To evaluate the results, the doctor compares the received indicators with normal values used in this period of pregnancy.

After the study, doctors determine which group the future mother can be attributed to. There are 2 groups - one of them includes women who do not have any disorders of the uteroplacental blood flow, the second includes expectant mothers who have reduced blood flow through the main main vessels.

Deciphering the results

Dopplerography shows a variety of abnormalities that occur even in the early stages of intrauterine development of the fetus. Doctors divide all pathological disorders into several degrees (classes) of severity. It is important to note that the main criteria are not absolute values ​​or any ratios, but the presence of pathology localization.

The table below shows the main research parameters that are used by doctors to issue an ultrasound conclusion:

If pathological disorders have arisen in the uteroplacental blood flow, then these values ​​\u200b\u200bare related to class 1A. In this case, there are no serious deviations in the blood circulation in the fetus. Also, in such a situation, there are no signs of intrauterine growth retardation and development of the unborn baby.

1B violations are characterized by the reverse picture. In this case, no pathological disorders in the uteroplacental blood flow occur. A decrease in the estimated indicators occurs in the blood vessels that connect the body of the fetus with the mother. In this clinical situation, signs of intrauterine growth retardation and growth of the unborn baby may also appear.

The second degree of disorders is characterized by the development of the most diverse disorders affecting many blood vessels. In this case, changes occur both in the uteroplacental blood flow, and in the placental and fetal arteries. This condition is already more unfavorable. However, such indicators are quite adequate for the fetus to live and not die.

The extreme, or third degree of violations is already a rather dangerous sign, indicating the presence of a severe violation of the blood supply to the fetus. In this case, the blood flow through the supplying blood vessels between the future baby and mother is significantly disrupted. If doctors do not urgently intervene at this time and do not correct this situation, then the fetus may die.

Any blood flow disorders in a pregnant woman are the reason for the appointment of a special treatment for her. In this case, repeated Doppler ultrasound may also be required to establish the dynamics of the development of pathological changes.

What is dopplerometry?

Doppler, dopplerography (dopplerography), ultrasound duplex examination of blood vessels is a method of ultrasound, which measures the speed of blood flow in the vessels.

Using the Doppler method of assessing blood flow, blood clots or atherosclerotic plaques that contribute to impaired blood flow can be detected.

When performing a duplex examination, these two methods (conventional ultrasound and Doppler) are used simultaneously. Conventional ultrasound provides an image of the structures of the blood vessels, while Doppler allows us to image and evaluate the characteristics of the flow of blood moving through the vessels. During a duplex examination, the doctor receives a color image of the vessel, with a certain encoding in color of the speed and direction of blood flow.

What types of Doppler are there?

There are the following types of Doppler (Dopplerography):

Doppler during pregnancy.

Dopplerography of cerebral vessels.

Dopplerography of the vessels of the neck.

Dopplerography of the vessels of the lower extremities.

Dopplerography of the arteries of the lower extremities.

Doppler (Doppler) during pregnancy.

Doppler, Doppler (Dopplerography) during pregnancy is an additional ultrasound method that allows you to evaluate the placental circulation and the "mother - placenta - fetus" system.

Dopplerometry has an important diagnostic value in the examination of pregnant women, especially in patients with bleeding disorders. To adequately assess the condition of the fetus, dopplerography is often performed in conjunction with cardiotocography and echography. The data obtained during the study can significantly affect the management of pregnancy and childbirth.

High information content, safety and the possibility of fetal Doppler ultrasound even in early pregnancy make this method indispensable in a comprehensive system of prenatal diagnosis.

At what time is dopplerometry performed during pregnancy?

Despite the fact that visualization of blood flow using Doppler is possible already at the 6th week of fetal development, the most informative study will be in the II and III trimesters.

The first Doppler ultrasound is usually performed at 20-24 weeks. Special indications for research at this time are violations of hemostasis in the patient, as well as the risk of preeclampsia, intrauterine growth retardation, hypoxia and fetoplacental insufficiency.

Planned dopplerography is usually performed at 30-34 weeks and is a mandatory component in a comprehensive assessment of the functional state of the fetus.

What is the peculiarity of Doppler during pregnancy?

Dopplerometry is a modern leading research method in obstetrics, which allows you to assess the state of the fetoplacental system of the unborn child.

Distinctive features of Doppler (Doppler) during pregnancy:

the principle of operation of Doppler ultrasound is based on changes in the frequency of the ultrasound wave depending on the speed of blood in various vessels of the umbilical cord, the aorta and cerebral arteries of the fetus, and the arteries of the uterus;

Dopplerography (Doppler) during pregnancy is similar to the usual ultrasound procedure. The study is carried out using a special Doppler sensor, which is equipped with all modern ultrasound diagnostic devices;

if conventional ultrasound gives an idea only of the structure of blood vessels, then dopplerography also shows the movement of blood in the form of a two-dimensional color image.

Unlike conventional ultrasound, Doppler is capable of:

determine the health of the baby's heart;

listen to the heartbeat, determine the patency and lumen of the vessels of the umbilical cord of the fetus;

determine how well the vessels of the fetus are supplied with blood;

detect insufficient functioning of the placenta and fetal hypoxia in the early stages.

What is color doppler during pregnancy?

During Doppler (Dopplerography) during pregnancy, a high-resolution color apparatus is used. This allows you to color the blood flow of the mother and child with different colors, which is especially important for the early diagnosis of childhood heart defects and developmental anomalies. Different colors are also used to depict different directions of blood flow.

Special indications for fetal dopplerography

When the size of the fetus does not correspond to the gestational age.

Abnormal amount of amniotic fluid.

When pathological conditions of the placenta are observed: premature maturation, etc.

If fetal abnormalities or chromosomal abnormalities are suspected.

When a woman has diseases such as diabetes, anemia, kidney disease, etc.

The presence of pathologies during previous pregnancies.

When the fetal heart rate is abnormal. If you suspect heart disease or other heart disease.

With premature contractions - they are visible on CTG (cardiotocography).

With gestosis pregnant.

With Rhesus conflict.

With high blood pressure in the mother.

With multiple pregnancy.

With the threat of miscarriage or premature birth.

ultrasound is sound waves with a frequency of over 20,000 hertz. The human ear is not capable of perceiving such. In modern medicine, these waves have been used for more than half a century to obtain accurate information about the state of tissues and organs of the human body.

Ultrasound for pregnant women: when to do

During pregnancy, ultrasound makes it possible to non-invasively examine the embryo and adjacent structures in the uterus of the expectant mother. This method is completely safe for both the baby and the mother. To date, using this method, it is possible to diagnose about 90% of fetal defects in utero.

Screening ultrasound examination is performed:

10-14 weeks of pregnancy (identification of possible chromosomal abnormalities);

20-24 weeks (study of the anatomy of the fetus);

32-34 weeks (detection of late malformations).

Additional examinations of pregnant women "Doppler"

Doppler This is a type of ultrasound scan. It is necessary for a real assessment of blood flow in the vessels of the fetus, uterus and umbilical cord. doppler ultrasound makes it possible to diagnose intrauterine hypoxia of the baby - an excessive supply of nutrients and oxygen. Doppler is recommended during the third scheduled ultrasound examination. The results obtained often allow the specialist to prescribe therapy that restores normal blood supply and nutrition to the fetus.

In modern prenatal diagnostics, more and more attention is paid to 3D ultrasound. This procedure makes it possible to scan the embryo, making its image in three planes. The method can be used already in the early stages of pregnancy. It makes it possible to timely diagnose even minor chromosomal anomalies, severe defects of the nervous and musculoskeletal systems. In the second and third trimester, such an examination is useful for studying the face of the child, some parts of the brain.

Another method of prenatal diagnosis is four-dimensional ultrasound. Distinctive parameter of the method 4D during pregnancy is the ability to have a good look at the fetus in motion in real time. Many gynecologists We are sure that such a study is more of an aesthetic benefit: thanks to it, parents receive a video depicting the life of their unborn baby in the mother’s stomach. But this is absolutely not true. A four-dimensional study also makes it possible to evaluate the child's behavioral responses in real time.

Are 3D and 4D ultrasounds safe for expectant mothers?

When using new ultrasound techniques, the emission is slightly greater than with standard ultrasound. Therefore, the expected benefit from their use should always outweigh the possible harm. Based on this, it can be argued that ordinary two-dimensional ultrasound remains the key in the diagnosis of malformations and the anatomical condition of the fetus.

In the last trimester, during a planned ultrasound, an additional Doppler study is performed. Expectant mothers are wondering how necessary this procedure is, and will it harm the child? Where can I take this study, and is it free?

Doppler

Modern technologies allow us to evaluate not only the internal organs of the baby, but also how comfortable it is for him to be there. For this, dopplerography is used.

Thanks to the study in the last terms, the doctor evaluates how well the child feels and whether he receives enough oxygen. This diagnostic method is very important for an objective picture of pregnancy, it is highly informative and easy to carry out. Ideally, women should undergo Doppler twice: at 20-24 weeks of pregnancy, and also at 30-32 weeks.

What is the difference between doplerometry during pregnancy and ultrasound

Doppler is an additional method of ultrasound. This procedure is carried out on the same ultrasound machine, only a different sensor is used. This sensor has stronger ultrasonic radiation from moving objects, therefore it can more accurately and deeply penetrate the organs of the fetus, explore the "mother-placenta-fetus" system. With it, you can see the vessels in the uterus, as well as assess the condition of the placenta. Therefore, this study can be carried out after 18 weeks of pregnancy, when the placenta completes its formation.

Features of the ultrasound procedure during pregnancy

A Doppler examination does not require any special preparation from the expectant mother, and can be performed on the same day as a conventional ultrasound. The study protocol is issued to the woman immediately after the procedure, since the diagnostic results are immediately visible on the monitor.

Dopplerography requires:

• lie horizontally on the couch, release the lower abdomen from clothing;
• the doctor applies a special gel to the stomach, which improves the conductivity of impulses;
• the doctor drives a special sensor over the abdomen, especially assessing the condition of the umbilical cord, arteries and blood vessels.

There are no contraindications to this type of diagnosis in pregnant women.

Doppler ultrasound

This diagnostic method is based on recording reflected ultrasound beams from moving objects, and the frequency of the waves will depend on the speed and direction of blood flow. The use of a special encoding of impulses allows you to display a picture of the vessels, assess their condition.

There are several types of dopplerography:

• duplex scanning: with it you can evaluate the vessels and blood flow, see the internal organs. The results are given in black and white;
• triplex scanning: examines blood flow and vascular patency. The color will not depend on the type of vessel or artery, but on the direction of blood flow.

Indications for the appointment of fetal dopplerography at different times

Doppler is most informative during the period of intensive fetal growth at 27-34 weeks.

In addition to the planned use of dopplerography, a woman may be prescribed this procedure for the following diseases:

• kidney problems, diabetes mellitus, Rh conflict, high blood pressure, preeclampsia;
• if an ultrasound scan reveals intrauterine growth retardation in a child, oligohydramnios or polyhydramnios, congenital pathologies, multiple pregnancy;
• the age of the future mother is more than 35 years;
• previous pregnancy ended in miscarriage or frozen pregnancy;
• in case of deviation from the norm of the results of CTG;
• prolongation of pregnancy;
• cord entanglement;
• carried out after an abdominal injury.

1 trimester

In the first trimester, such a study is not prescribed, since by this time the placenta has not yet been completely formed.

2 trimester

Scheduled ultrasound is carried out starting from the 22nd week, when the "mother-placenta-fetus" system is fully established. You can conduct Doppler as often as you like, if there is evidence for this.

Is dopplerography prescribed before the birth itself

If, during the examination at 22-24 weeks, a woman was found to have any deviations in the Doppler protocol, then she can be diagnosed again at 34-36 weeks. Also when the pregnancy is over at 40 weeks, to make sure that the arteries and aorta are still supplying the baby with oxygen in the right amount.

Is doppler harmful to the fetus

There are many opinions about Doppler ultrasound. The harm of this study has not been proven. However, most expectant mothers are suspicious of this procedure.

Doctors call for this method of diagnosis, because it allows you to identify most fetal diseases at an early stage. Moreover, neither the mother nor the child feel any discomfort during the ultrasound examination.

Therefore, stories on the Internet of mothers that the baby was spinning violently during this procedure, or wrapped around the umbilical cord, do not indicate that this was due to Doppler. Yes, the baby may move during Doppler, but this will also happen during the ultrasound, as the child feels how cool gel is applied to the abdomen.

What does a doppler study show?

Doppler ultrasound shows the state of the mother-placenta-child system. All the information collected helps to assess the state of the work of blood vessels and blood flow.

During the ultrasound examination, the indices of vascular resistance are assessed:

• the ratio of systolic and diastolic pressure;
• pulsation and resistance indices;
• the parameters are compared with the norms, and a protocol is made.

Each of these parameters is evaluated for each artery. Based on the results obtained, the obstetrician concludes whether the child suffers from a lack of oxygen.

The blood flow of the umbilical cord artery of the fetus: the norm and deviations

The most accessible to the study are the vessels of the umbilical cord and uterine arteries. It is desirable that when this study is carried out, the baby was at rest, and the pregnant woman lies on her back.

The umbilical cord usually has two arteries and one vein. If some kind of anomaly is detected, for example, instead of two arteries there will be one, then the fetus will suffer from a lack of oxygen, due to which there will be a developmental lag. It happens that a child can adapt to this condition, but he will be born with a small body weight. If a violation of a single artery is also detected, then, most likely, an emergency delivery will be prescribed.

Violation in the blood flow of the umbilical cord is when all indicators are increased.

Uterine blood flow: norm and pathology

Uzist determines the state of blood flow, both in the left and right arteries to obtain a complete diagnosis result. Sometimes the rate of blood flow in the uterus can be increased for some indicators, but most often this does not have any negative consequences. Since this is due to the fact that the mother's body unconsciously helps the child, enriching it with oxygen.

It happens that a violation of the uterine blood flow occurs in only one artery. This can cause late toxicosis. If the pregnancy develops normally, then the placenta in this case is out of danger.

Heart rate: norm and deviations

Heart rate constantly needs to be monitored throughout pregnancy. This indicator indicates the harmonious and timely intrauterine development of the baby:

• from 8 to 10 weeks, the rhythm accelerates from 170 to 180 beats per minute;
• at 11-12 weeks of embryonic development, the heart rate reaches 160 beats with a tolerance of 30 units;
• from 15 weeks until delivery, heart rate will be regularly recorded during scheduled examinations by a gynecologist, as well as with the help of Doppler and CTG;
• from week 20, the lower heart rate will be 85 beats per minute, and the upper allowable rate will be 200 beats.

Pathologies in the direction of increasing the number of strokes are more common. This is usually associated with oxygen starvation of the fetus - hypoxia.

How is fetal hypoxia determined?

In this case, increased IR and LMS in the uterine arteries will indicate fetal hypoxia, which will lead to developmental delay, since the baby does not receive the necessary oxygen. Also, an increase in the indices of the umbilical arteries is considered a symptom of feto-placental insufficiency. With this sign, vascular pathology is detected, which means that the fetus is already suffering, and this is a sign of preeclampsia.

Degrees of violation of uteroplacental circulation

Deviations from the norm are diagnosed in violation of the uteroplacental circulation, which has three degrees:

1 A degree

Changes are found only in the uteroplacental blood flow, developmental delay syndrome is not more than 10%. Fetal-placental circulation in this case is normal.

1 B degree

It is characterized by the norm of uteroplacental circulation, but deviations in the fetal-placental circulation. Complications may occur in 20%.

2 degree

Violations in this case occur in the bloodstream of the vessels in both the fetus and the uterus. This degree can occur at 36-38 weeks and quickly flows into the third.

3 degree

With this degree, the fetal blood supply is in critical condition. Such a diagnosis can be made when the pregnancy is overdue.

SDO norms by week in the table

Each period in weeks has its own LMS norm. If the results obtained are normal, then the child has enough of everything and the mother has nothing to worry about. However, if any deviations are found, then a certain course of treatment will be prescribed to prevent possible developmental pathologies.

	week of pregnancy	FROM TO
Uterine arteries	22, 23 weeks	Up to 2.3
24, 27 weeks	Up to 2.16
28, 31 weeks	Up to 2.13
32, 35 weeks	Up to 2.15
36, 41 weeks	Up to 2.06
spiral arteries	22, 23 weeks	Up to 1.74
24, 27 weeks	Up to 1.75
28, 31 weeks	Up to 1.76
32, 35 weeks	Up to 1.71
36, 41 weeks	Up to 1.68
umbilical artery	22, 23 weeks	Up to 4
24, 27 weeks	Up to 3.83
28, 31 weeks	Up to 3.18
32, 35 weeks	Up to 2.83
36. 41 weeks	Up to 3.18
Fetal middle cerebral artery	22, 23 weeks	Up to 4
24, 27 weeks	Up to 3.83
28, 31 weeks	Up to 3.18
32, 35 weeks	Up to 2.81
36, 41 weeks	Up to 2.26

Summary values ​​​​of the norms of planned fetal dopplerography: table

The table shows only approximate norms of the indices of the value of the vessels of the uterus and fetus. Usually the obstetrician looks at them in a complex and prescribes treatment if necessary, correlating the data with the mother's condition and CTG data.

Since the blood flow rate changes regularly during pregnancy, it is necessary to correlate the obtained readings with the gestational age.

dangerous moments

Only a specialist needs to trust the interpretation of the results of the ultrasound scan, as he looks at the general indicators and individual characteristics. The tables show general guidelines.

A change in the direction of blood flow in the umbilical cord means a delay in the development of the child in utero. Venous flow cannot be assessed using indexes. The indicator will be zero blood flow values. This can occur with fetal malnutrition, heart disease, non-immune dropsy.

Dopplerometry is an important part of monitoring pregnancy, which helps not only to save the child, but also to influence its further development. Thanks to such diagnostics, it was possible to reduce many intrauterine deaths, or the birth of children with severe pathologies. The result of such a study is timely therapy and the birth of a child without diseases.

Useful video

And the Doppler study uses a similar mechanism for obtaining data: the device analyzes the nature of the ultrasonic signal reflected from tissues or particles in the liquid. The main difference is that ultrasound produces an image of dense tissues in a static position, that is, internal organs. According to the reflected signal, one can judge the presence or absence of anomalies in the development and position of organs.

When conducting Dopplerography, the Doppler effect is used: the speed of reflection of an ultrasonic signal from moving blood particles is measured. Thus, it is possible to measure the blood flow velocity in the uterus-placenta and placenta-fetus system, to find out if there are any disturbances in the blood flow of the umbilical cord or placenta, to calculate the heart rate of the child, to determine whether the brain and other organs of the baby receive enough blood.

This is invaluable information for diagnosing many diseases, but at the same time, during Doppler ultrasound, the intensity of ultrasound is significantly higher than with ultrasound, up to 1500 mW / cm² with color Doppler ultrasound against a maximum intensity of 100 mW / cm² for ultrasound.

There is a lot of controversy associated with this about the potential harm of Doppler, or as this study is simply called, Doppler. They are conducted both among scientists and medical practitioners, and among future parents.

There are two main types of doppler: a duplex exam, which examines vascular patency and blood flow velocity, and a triplex exam, which adds color to the image to more accurately determine the state of blood flow. The triplex method requires the use of a higher intensity of ultrasound, so it is used only when necessary.

• Many expectant mothers are concerned about the question - is it possible for them. And I want to take care of my appearance. We give only exhaustive answers!
• It is very important during pregnancy to monitor your well-being and not miss even the slightest signal that indicates changes in the health of the mother and fetus. Learn all about basal temperature and its changes.

Also, portable (fetal) dopplers appeared on the market not so long ago, allowing you to hear the baby's heartbeat and track its changes at home. The cost of such devices starts from 3 thousand rubles, but doctors do not recommend their purchase, since even small doses of exposure to ultrasound with constant use of the device can theoretically have a negative impact on the development of the fetus, and in this case the risk is not justified by medical purposes. You will be able to hear the baby's heartbeat only closer to the late stages of pregnancy, by that time any anomaly will already be detected during standard ultrasound and dopplerography. Therefore, do not expose the child to excess radiation.

What week can I do Doppler during pregnancy?

Doppler examination is prescribed in two cases. Firstly, for preventive purposes, once or twice, depending on the specific clinic, at 23-24 weeks of pregnancy and more often at 30-34 weeks. In addition, if there are indications, Doppler can be prescribed at any stage of pregnancy. It should be noted that with a successful pregnancy, this study may not be prescribed at all, it is not included in the list of mandatory.

A preventive study is carried out in order to identify a violation of blood flow in the umbilical cord or placenta. Most doctors are against conducting Doppler before the 20th week of pregnancy, since the blood flow has not yet been formed, so the readings will be unreliable and inaccurate. And it is safer to calculate the heart rate in the early stages using a conventional ultrasound. Others, on the contrary, consider dopplerography a good way to detect pathologies in the development of the cardiovascular system in the fetus starting from the 5th week.

• Some maternal illnesses: diabetes, kidney disease, hypertension, certain diseases of the cardiovascular system. In this case, the study can be very useful: for example, if the mother has diabetes, Doppler helps to more accurately determine the risk group and choose the right treatment method.

• Multiple pregnancy- also a risk factor, the study will provide additional information necessary to identify various pathologies.
• – if the cause is unknown, testing may help in the diagnosis.
• Mismatch between fetal size and gestational age- the reason for this may be fetal hypoxia or other disorders that will be visible with Doppler sonography.
• Rh sensitization- Doppler can detect increased blood flow in the umbilical cord, which may indicate the development of complications.
• Emerged suspicion of pathologies during cardiotocography or ultrasound - Doppler can give a more complete picture of the state of blood flow and help identify the causes of anomalies visible on ultrasound or cardiotocogram and, accordingly, choose treatment tactics.

In case of blood flow disorders in the systems of the uterus-placenta and placenta-fetus, three stages are distinguished according to the degree of severity: stage 1 - disorders in one of the two systems, stage 2 - disorders in both systems, but not critical, stage 3 - critical disorders in the fetal-placental blood flow, uteroplacental blood flow may be impaired or preserved. In the latter case, it is often assigned. In the first two, observation is mandatory, the rest depends on the nature and severity of the violations.

Is Doppler safe for the fetus?

On the net, you can easily find a single, but often cited article that damages cells under the action of ultrasound can occur at an intensity of more than 20 mW / cm², and during Doppler ultrasound, the intensity can reach 1500 mW / cm². This gives rise to the refusal of some women, even if there are indications for undergoing a study. It is worth saying that the effect of ultrasound at high intensity can indeed lead to tissue injury and the subsequent development of pathologies, since ultrasound puts pressure on tissues and heats them up. But most studies claim that this occurs at an intensity of more than 10 W/cm², which is well above the strongest ultrasound in color Doppler.

In addition, for 30 years of using Doppler ultrasound during pregnancy, no negative consequences have been identified in the further development of the fetus. It should be taken into account that the radiation does not last continuously, but in streams for thousandths of a second, in addition, up to 50% is absorbed by the surrounding tissues, so the actual effect on the fetus is much less than the values ​​prescribed in the characteristics of the devices.

Dopplerography has been prescribed for you: should I do it or not?

Any study provides information by influencing the object of study in one way or another and analyzing the response to this effect. Therefore, absolutely harmless diagnostic methods practically do not exist. And for the same reason, many doctors do not recommend Dopplerography “just because” and “to calm down”: radiation of any power affects the child, although studies of specific consequences have not yet been revealed. At the same time, a Doppler study often helps to identify pathologies in the development of the fetus that can be missed on ultrasound, therefore, if any anomalies are suspected, a Doppler is prescribed without fail. In such cases, the risk of complications, even if they are possible, is much less than the risk that the child's development is not going as it should, and without research, the doctor will not know about it or find out too late.

When prescribing any analysis, it is better to ask the doctor about why and how much it is necessary. If you hear specific reasons in response, dopplerography is necessary, it can help in the timely diagnosis of many pathologies and subsequently save the life or health of your child. Whether or not to conduct this study during the normal course of pregnancy is up to you. But in this case, when dopplerography is performed as a preventive measure, two standard studies during pregnancy should be limited.