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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(05): 519-531
DOI: 10.1055/s-0042-1743097
DOI: 10.1055/s-0042-1743097
Review
Doppler Ultrasound of the Umbilical Artery: Clinical Application
Ultrassonografia Doppler da artéria umbilical: Aplicação clínica
Abstract
Objective To provide a survey of relevant literature on umbilical artery Doppler ultrasound use in clinical practice, technical considerations and limitations, and future perspectives.
Methods Literature searches were conducted in PubMed and Medline, restricted to articles written in English. Additionally, the references of all analyzed studies were searched to obtain necessary information.
Results The use of this technique as a routine surveillance method is only recommended for high-risk pregnancies with impaired placentation. Meta-analyses of randomized trials have established that obstetric management guided by umbilical artery Doppler findings can improve perinatal mortality and morbidity. The values of the indices of Umbilical artery Doppler decrease with advancing gestational age; however, a lack of consensus on reference ranges prevails.
Conclusion Important clinical decisions are based on the information obtained with umbilical artery Doppler ultrasound. Future efforts in research are imperative to overcome the current limitations of the technique.
Resumo
Objetivo Compilar informação relevante proveniente da literatura atual sobre a ultrassonografia Doppler das artérias umbilicais (AUs) na prática clínica, considerações e limitações técnicas e perspectivas futuras.
Métodos A pesquisa bibliográfica foi realizada nos bancos de dados PubMed e Medline e restringiu-se a artigos escritos na língua inglesa. Recorreu-se também à bibliografia dos artigos selecionados, quando necessário, para obter informação relevante.
Resultados A utilização desta técnica como método de vigilância de rotina está apenas recomendada em gravidezes de alto risco com disfunção placentar. Metanálises de estudos randomizados mostraram que o seguimento obstétrico baseado nos achados do Doppler da artéria umbilical pode melhorar a mortalidade e a morbilidade perinatal. É consensual que os valores dos índices Doppler da AU decrescem com o avanço da idade gestacional. No entanto, há ainda muita incerteza quanto aos valores de referência.
Conclusão As informações obtidas através da AU Doppler US são a base para muitas decisões clínicas importantes. Trabalhos de investigação nesta área são essenciais para tentar colmatar atuais limitações da técnica.
Palavras-chave
doppler - placenta - artéria umbilical - vigilância fetal - insuficiência placentáriaConclusion
The UA Doppler US is an invaluable screening tool for high-risk pregnancies and on which important clinical decisions depend. Future investments in research are imperative to attempt to overcome the current limitations of the technique.
Publication History
Received: 05 July 2021
Accepted: 18 November 2021
Article published online:
11 April 2022
© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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