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Pulsed Umbilical Artery Doppler Ultrasound Findings in Management of High-Risk Term Pregnant Women during Labour

DOI: 10.4236/ojog.2017.71015, PP. 139-146

Keywords: Doppler Ultrasound, Velocimetry, Early Neonatal Death, Umbilical Artery

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Abstract:

Purpose: Intrapartum Doppler velocimetry is a non-invasive investigation method. This method is useful for evaluating the pathophysiological mechanisms underlying changes in fetal heart rate. This study aimed to determine the usefulness of Doppler ultrasound findings during labor in high-risk women on determining the mode of delivery and outcome of the newborn. Methods: A cross-sectional study was conducted from January 1, 2015 to December 31, 2015 on 100 high-risk pregnant women during labor. The study was performed in the Maternity Teaching Hospital in Erbil City, Kurdistan Region, Iraq. Results: The majority of women (77%) had a normal end-diastolic blood flow pattern through the umbilical artery. A total of 76.9% of those with abnormal Doppler results had a Cesarean delivery compared with only 9.5% of those with normal Doppler results (p < 0.001). The rate of early neonatal death was significantly higher (15.4%) in women with abnormal Doppler results than in those with normal Doppler results (1.4%, p = 0. 016). Admission to the neonatal intensive care unit was significantly more frequent in women with abnormal Doppler results than in those with normal Doppler results (61.5% vs. 17.6, p < 0.001). The same pattern was seen in the Apgar score in the first (p = 0.07) and fifth minutes (p = 0.01). Conclusions: Abnormal umbilical artery Doppler ultrasound findings in high-risk pregnancies for women in labor are associated with increased rates of emergency cesarean sections and a poor outcome of the newborn.

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