Doppler Ultrasound in Obstetrics & GynecologyDev Maulik By allowing noninvasive assessment of circulation, development of Doppler sonography has revolutionized medical diagnostics. The fea sibility of the medical application of Doppler sonography was demon strated more than three decades ago, and the first report of Doppler velocimetry of the fetal circulation was published two decades ago. Over the years, impressive technological innovation and advances in clinical research have promoted the use of this method in medical practice. There also has been phenomenal expansion in research on the obstetrical and gynecological applications of Doppler sonography. In obstetrics, Doppler sonography has allowed unprecedented insight into the pathophysiology of human fetal response to in utero stress. This ushered in the possibility of using the method for antepartum fetal surveillance, so that timely recognition of fetal compromise and appropriate intervention could improve perinatal outcome. Numer ous clinical studies mostly have confirmed, but occasionally have re futed, the diagnostic efficacy of Doppler velocimetry in various preg nancy disorders. More significantly, the benefits of umbilical arterial Doppler investigation in reducing perinatal mortality in high-risk pregnancies have been affirmed by randomized clinical trials. In addi tion, the introduction of fetal Doppler echocardiography has not only tremendously increased our understanding of human fetal central circulation in health and disease, but also has enhanced our ability to diagnose congenital heart disease in utero. In addition, significant strides have been made in the gynecological applications of Doppler sonography, including general gynecology, infertility, and oncology. |
