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Fetal circulation is evidence
Doppler effect: When we use equipment that detects venous or arterial circulation and amplifies the sound waves we can “hear” the blood flow clearly and if we have means to graph the sound then we will have visible waves (spectral image); and if in addition, everything that moves fast we color it depending on the direction of flow then we will have the so-called color Doppler that we use in advanced studies and that has a representation in colors of reds to blues, wave graphs and sounds audible by the attendees to the study.
Doppler ultrasound prevention: Doppler has become so common that it is an integrated part of most of the advanced studies of the fetus, in the absence of known problems we evaluate the normality of the fetoplacental circulation for everyone’s peace of mind. Occasionally there are unexpected circulatory disorders that impose a stricter control of pregnancy, which allows us to overcome potential complications
Doppler Ultrasound Note: when the obstetrician detects problems such as Hypertension, Preeclampsia, Diabetes, Maternal Chronic Diseases, Fetal Growth Disorders, decreased Amniotic Fluid, etc. we are in the presence of formal instructions to perform an Eco Doppler. We determine:
(1) if there is real commitment to the baby’s health,
(2) if there is a need for early termination of pregnancy,
(3) if there is risk data of fetal neurological injury,
(4) if there is a risk of stillbirth,
(5) if we should make suggestions in the management of pregnancy.
The most studied territories are the Umbilical Cord (Fig. 1), the Middle Cerebral Artery (Fig. 2), both of the fetus, the uterine arteries (of the mother) and optionally some arterial and venous systems of the fetus. The Cordo-Cerebral profile (comparison of cord and middle brain flows) is the most used for clinical decision making in complicated pregnancy.
Doppler in predicting Preeclampsia: In the general low-risk population, it is possible to detect and predict with a certain degree of success (50%) those patients who will suffer some type of hypertensive disease associated with pregnancy through the assessment of maternal uterine circulation .
Clinical Doppler
Normal fetal Doppler in the umbilical artery: well oxygenated baby
Normal fetal Doppler in the middle cerebral artery
Circular double umbilical cord
Normal Doppler of the uterine artery
Uterine Doppler suggestive of Preeclampsia risk in maternal uterine arteries
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Chronic fetal distress: These two eco-photographs show a severe alteration of arterial and venous flow at the level of the umbilical cord in a case of Intrauterine Growth Delay. There was a need to terminate the pregnancy at 32 weeks and a male of 1200 g was obtained. in excellent conditions that, despite what was expected, did not require respiratory support.
Umbilical blood flow where it is shown that the blood that goes from the baby to the placenta is returned to the baby due to the placental alteration. The exchange is very bad, the baby has an inadequate supply of oxygen and nutrients; the placenta is not able to maintain the baby’s life for much longer, the pregnancy is interrupted immediately
In the venous circulation we can observe that there are abnormal pulsations that imply imminent cardiac failure due to fetal deoxygenation due to placental insufficiency, this baby has a heart failure. This baby is extremely committed and 4 weeks smaller than expected, without amniotic fluid and at any time will start irreversible brain damage and later fetal death will occur (in no more than 1-2 weeks)