Doppler velocimetry in pregnancy

Since the late 1970s, Doppler velocimetry has been investigated extensively for use in obstetrics. Initially, this technique showed promise for the management of certain complications of pregnancy; this promise has yet to be fulfilled. Doppler velocimetry of either the uterine or umbilical vessels, which showed some merit in selecting growth-retarded fetuses at particular risk, has neither become a screening tool for intrauterine growth retardation nor proven clinically successful in improving fetal outcome. Likewise, its use for other complications of pregnancy (eg, postdate pregnancy, twin pregnancy, and diabetes) has not led to improved pregnancy outcome. More recently this technique has been used to study other vascular beds. Changes in the Doppler characteristics of these vascular beds may demonstrate the fetal response to its environment. These investigations provide the potential for a better understanding of fetal physiology; however, it has yet to be shown by prospective evaluation that their application results in improved pregnancy outcome. This review defines the uses and limitations of Doppler ultrasound in current obstetric practice.