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A Journal on Obstetrics and Gynecology

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Minerva Ginecologica 2014 October;66(5):455-9

language: English

Doppler analysis of the umbilical artery: why we must prefer the free loop of the cord

Cohen J. 1, Wauquiez M. J. 2, Janse-Marec J. 2

1 Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France;
2 Department of Gynecology and Obstetrics, Institut Hospitalier Franco‑Britannique, Levallois, France


AIM: The main objective was to confirm with modern tools the former assertion that there is a vascular resistance gradient along the umbilical cord.
METHODS: We performed a prospective observational study in a population of women with third trimester monofetal and uncomplicated pregnancies during two months. Pulsatility Index and Resistance Index were calculated on three sites: placental end, free loop and fetal end of the cord.
RESULTS: Sixty-five pregnant women were included in the study. Mean gestational age was 32 weeks and 3 days. We confirmed the presence of a resistance gradient with a significant increase of both Resistance and Pulsatility Indices from the placental toward the fetal end of the cord (Resistance Index = 0.61±0.07 at placental end and 0.66±0.11 at fetal end [P<0.001]. Pulsatility Index = 0.97±0.17 at placental end, and 1.06±0.25 at fetal end [P<0.001]).
CONCLUSION: Resistances seem higher when doppler waveform analysis of the umibilical artery are performed at the fetal end of the cord. We recommend the free loop insonation site to obtain a better sensitivity. International guidelines strongly need to be well diffused in order to standardize practices.

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