H DOPPLER

A.
A. M
' M- K A






H Doppler . H , . T 1/3 . , . H . Rhesus, 73% . , , . , / , Doppler . . , o . , . , , , . , , , . T Doppler , .
: Doppler, , IUGR, , , , , , , .

EIAH
H Doppler . H , Doppler .

MHTPIAIA APTHPIA
H . , . M 12 / Doppler . E , .

EIKTE POH

O . O , PI (pulsatility index), , . A, RI (resistance index) / , . O , : .

ANTITAEI MHTPIAIN APTHPIN

H , . H 24-26 . E , . 20 , 15% . T 24 9%, 5% .

OMAIKH APTHPIA

H Doppler 1977. O , . , , , . K , , . H .

PAKIKH AOPTH
H , , 45 . H , , , , 50% .

MEH EKEAIKH APTHPIA
M Doppler . . , , . M Doppler Willis, . , 10 . H .

EBIKH KYKOOPIA
T . , . T , , . M 50% , 50% . T . , , , , .

OMAIKH EBA
T , , . A , (15-25 cm/s) . H .

EBH OPO

O , . H 2 . ( 1/3 ). T . , ( ) . , . , . , .

KAT KOIH EBA

H . , . H . H (S) , (D), , ( ) . T , , .

EIKTE POH
T 1993 193 , , . O PIV (Peach Velocity Index), (PI) . O , .

EMBPYKH YOIA
O . , ( 1/3) , . A Everest ( ) . M pO2 pH , pCO2 . , , .
E . , , . A , . H :
I. , pO2
II. ,
III.
H , . H , , , 5-10% 25% . T IUGR 30% , 40%.

OMAIKH APTHPIA
IUGR . H . , PI . , 60% . H 80% 90%. H , Doppler .

DOPPLER OMAIKH APTHPIA KAI EMBPYKH YPAIA

IUGR 0-40%, 0-30%. , CTG ( 0-50%, 0-30%.)
T 2000 Cochrane Database Systematic Review 4 14.000 Doppler , . O .

DOPPLER OMAIKH & EPIENNHTIKH NHIMOTHTA E KYHEI YHOY KINYNOY

Doppler . H Doppler 1987 300 . Doppler, , . O Doppler . H , 1991, 2.178 . , IUGR 70%, 20%. : , 35% IUGR 80%.
T 2000 Cochrane Database Systematic Review 11 7.000 -. Doppler, Doppler 30%, 17% 50% .
T 1994 - 12 Doppler . Y (44%), (20%) (52%), Doppler 38%. Y , . T , IUGR, Doppler . I IUGR, 90% , 12 .

ANAKATANOMH

T ( , ) E, . T . O , . O . , . H 2 . H . T . , , . H , . Y :
,

E , CTG . O . , . M , . , . H , . H CTG. , . O .

RHESUS EYAIHTOOIHH

Rhesus, , . 6 g/dl, . H , , , . A . H , , , , .
T , . M Doppler , , . I , , .
To 1990 PI, . , . H . T 0, . O 2000 Lancet. . X 1,29 MoM , 73% .
Rh , , , . H PO2, PO2 pH, PI . A , .

AKXAPH IABHTH

O . , , . , . T - , . A , . A , , . E . T ( ) .
H . H , . , .
O Doppler . T . T PI ( PI) ( PI).
, . H . , , , IUGR. T . PI . A pH . E, Doppler.

POPH PHH YMENN

O 10% , 70% . 1/3 . , 1/3 1/3 . , 5 , , , 5 . , .
: . O , 50% 20 , 20% 20-24 5% 24 . T . , PO2 pH , , . M , .
T Doppler , . T . M , Doppler . M, , IUGR . ( , ), , . O . T 2000 20 24 . , pH 95 .. 63% 2 .

AYTOANOA NOHMATA

O 1 1.000 . (15%), 10%. O , . T 25% E , IUGR 20% . O E (1 20.000 ) , (anti Ro/SSA, SS-B/Lo) . , E (15%).
T , , , . T 50% 16 30% IUGR.
Doppler E . , , , , IUGR. IUGR, . H IUGR.

APATAH KYHH
H . , . T DNA 40 , 37 . , 33% . H . H , . M IUGR.
Doppler ( ), . O 4 . H 5 , 3 1 . H 3 2. O , , IUGR. H , . .

IYMH KYHH

H 1% . 1/3 , 2/3 . . 10-24 2,5%, 12%. H 6 , . O 24-32 1-2%. 9% 5%. IUGR 10% , (34% 23% ).
, . 25% . Doppler 80 90 , IUGR. A, , , . Doppler , . T pH . T Doppler .

Summary

Psarra A, Mamopoulos A.
Doppler velocimetry in high risk pregnancy.
Hellen Obstet Gynecol 14(3):283-291, 2002

Doppler velocimetry is a non invasive method of studying fetal haeomodynamics. The examination of the uterine and umbilical arteries provides information regarding the uteroplacental and fetoplacental units while the examination of the fetal vessels is indicative of the changes that occur in response to hypoxia. 1/3 of IUGR foetuses develop hypoxia. The fetal respond to uteroplacental insufficiency is cerebral vasodilatation and peripheral vasoconstriction. Development of acidosis is reflected in the changes of the venous circulation. In Rhesus sensitization the velocity of the middle cerebral artery predicts 73% of fetuses with anemia. In maternal diabetes mellitus impedance to flow in the uterine and umbilical arteries is not related to maternal glycemic control. Impedance to flow in the uterine arteries may be normal even in patients with nephropathy and vasculopathy. In preterm prelabor amniorrhexis, intrauterine infection is not associated with altered fetal oxygenation or vasocon-striction in the utero- or fetplacental circulation and Doppler does not provide a useful distinction between infected and non-infected cases. In systemic lupus erythematosus it is uncertain if impedance to flow in the uterine arteries is increased. In antiphospholipid syndrome, the development of preeclampsia and IUGR is preceded by increased impedance to flow in the umbilical and possibly in the uterine arteries. In post term pregnancies impedance to flow in the uterine arteries is normal. In post term pregnancies with adverse outcomes, impedance to flow in the umbilical arteries may be increased or normal, impedance to flow in the middle cerebral artery may be decreased and blood flow velocity in the fetal descending aorta may be decreased. In twin pregnancies, impedance to flow in the uterine arteries is lower than in singleton pregnancies, while impedance to flow in the uterine arteries is not as predictive as in singleton pregnancies of the subsequent development of preeclampsia. Doppler velocimetry is useful in the evaluation of twin pregnancies complicated with IUGR or twin-to-twin transfusion syndrome.
Key words: Doppler, high risk pregnancy, IUGR, preeclampsia, diabetes, amniorrhexis, lupus erythematosus, antiphosphoslipid syndrome, post term, twins.

3rd Department of Obstetrics - Gynecology, Aristotle University of Thessaloniki

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