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REVIEW LABOR AND DELIVERY
Minerva Obstetrics and Gynecology 2021 February;73(1):94-102
DOI: 10.23736/S2724-606X.20.04698-5
Copyright © 2020 EDIZIONI MINERVA MEDICA
lingua: Inglese
Intrapartum Doppler ultrasound: where are we now?
Andrea DALL’ASTA 1, 2 ✉, Tullio GHI 1, Ilenia MAPPA 3, Pavjola MAQINA 3, Tiziana FRUSCA 1, Giuseppe RIZZO 3, 4
1 Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy; 2 Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK; 3 Division of Maternal and Fetal Medicine, Cristo Re Hospital, Tor Vergata University, Rome, Italy; 4 Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
Intrapartum hypoxic events most commonly occur in low-risk pregnancies with appropriately grown fetuses. Continuous intrapartum monitoring by means of cardiotocography has not demonstrated a reduction in the frequency of adverse perinatal outcome but has been linked with an increase in the caesarean section rate, particularly among women considered at low risk. Available data from the literature suggests that abnormalities in the uterine artery Doppler and in the ratio between fetal cerebral and umbilical Doppler (i.e. cerebroplacental ratio [CPR]) are associated with conditions of subclinical placental function occurring in fetuses who have failed to achieve their growth potential regardless of their actual size. In this review we summarize the available evidence on the use of intrapartum Doppler ultrasound for the fetal surveillance during labor and the identification of the fetuses at risk of intrapartum distress.
KEY WORDS: Placental insufficiency; Ultrasonography, Doppler; Review