Version User Scope of changes
Feb 25 2009, 12:59 AM EST (current) AndyC
Feb 19 2009, 5:40 AM EST AndyC

Changes

Key:  Additions   Deletions
Ultrasound scanning guidelines
  • Umbilical Artery Doppler (UA)
  • Middle Cerebral Artery (MCA)
  • Ductus Venosus Doppler (DV)

Umbilical Artery Doppler


Umbilical Artery Doppler should be performed when:
  • fetal biometry indicates FGR/I.U.G.R
  • Amniotic fluid volume is reduced
  • Maternal medical conditions related to placental insufficiency including:
    • pre-eclampsic toxemia (PET)/pregnancy-induced hypertension (PIH)
    • hypertension
    • SLE and other auto-immune disorders that complicated pregnacy
  • Maternal diabetes
  • Growth discrepancy in twin pregnancy (significant discrepancy is a 20% difference in EFW or greater than 20mm difference in AC)
Assess:
  • Mid cord Pulse Wave spectral trace of the umbilical artery (ideally during fetal apnoea). Obtain an R.I by averaging 5 or more cycles from one trace using an auto-calculation tool, or a single cycle R.I obtained manually (depending on signal quality)
  • Amniotic fluid volume
  • Fetal position and presentation

Documentation:
  • Mid cord Pulse Wave spectral trace of the umbilical artery with R.I measurement
  • Amniotic fluid volume (AFI)
  • Presentation

Middle Cerebral Artery (MCA)

Should be obtained if Umbilical Artery Doppler is equivocal or abnormal

Assess
:
  • Pulse Wave spectral trace obtained in the proximal portion of the MCA. Obtain an R.I. by averaging 5 or more cycles from one trace using an auto calculation tool, or a single cycle R.I obtained manually (depending on signal quality)
Documentation:
  • Pulse Wave spectral trace of MCA with R.I. measurement

Ductus Venosus Doppler (DV)

Should be obtained if the MCA or UA are abnormal

Assess:
  • Pulse Wave spectral obtained in the distal end of the DV. A single cycle, manual measurement of the S/a ratio should be obtained
Documentation
  • Pulse Wave spectral trace of Ductus Venosus with S/a measurement


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