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02 April 2022, Volume 38 Issue 4 Previous Issue    Next Issue

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Application of umbilical artery blood flow monitoring in obstetrics. LIAN Yan 2022, 38(4): 392-395.  DOI: 10.19538/j.fk2022040103 Abstract ( )   Umbilical artery blood flow monitoring is widely used in obstetrics as a non-invasive method for evaluating fetal placental hemodynamics. Umbilical artery doppler blood flow waveform mainly reflects the vascular resistance of placenta，which is affected by the development of villous blood vessels. Meanwhile，gestational age，fetal heart rate，fetal respiration and hiccup，fetal movement，sampling position of umbilical cord，fetal sex，placental weight and fetal weight also have certain influence .Evidence-based medical evidence recommends umbilical artery Doppler ultrasound as  fetal monitoring method for fetal growth restriction and twin selective growth restriction. The significance of umbilical artery blood flow monitoring in low-risk populations remains controversial. Absence of end-diastolic blood flow or end-diastolic reflux is significantly associated with significantly poor perinatal outcomes，and care should be taken to exclude congenital abnormalities and aneuploidy of the fetus. Obstetric management of abnormal umbilical artery blood flow depends on the severity of the abnormal umbilical artery Doppler findings，the severity of the underlying obstetric complications，and the gestational age，which should be given individualized management.

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Application of fetal middle cerebral artery blood flow monitoring in obstetrics. TU Peng, RAN Su-zhen, QI Hong-bo 2022, 38(4): 395-398.  DOI: 10.19538/j.fk2022040104 Abstract ( )   The spectrum of fetal middle cerebral artery （MCA）reflects the early adaptation of fetal cardiovascular system to hypoxia or blood flow redistribution，and its measurement requires standardization，which has become one of the hot spots of clinical application of fetal hemodynamics in recent years. Recently，a number of retrospective and prospective clinical studies with large samples have reported the assessment indicators of MCA，the range of reference values and the cut-off values applied to various clinical diseases. Based on the ISUOG fetal Doppler flow spectrum monitoring guidelines（2021），this paper analyzes and summarizes high-quality studies related to fetal MCA spectrum，and provides reference for its standardized clinical application.

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Application of venous ductus flow monitoring in obstetrics. CAO Li, LI Xiao-tian 2022, 38(4): 399-402.  DOI: 10.19538/j.fk2022040105 Abstract ( )   Venous ductus plays an important shunting role in fetal circulation. The paper described the anatomical, hemodynamic and Doppler spectrum characteristics of venous ductus, and summarized the clinical value of prenatal monitoring of ductus venosus flow in fetal chromosomal abnormalities, congenital heart disease screening, intrauterine growth restriction, fetal hydrops and twin-twin transfusion syndrome.

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Significance of uterine artery blood flow monitoring in obstetrics. WAN Shu-ting, WANG Xie-tong. 2022, 38(4): 403-406.  DOI: 10.19538/j.fk2022040106 Abstract ( )   The waveform of uterine artery blood flow is high resistance low diastolic flow and early diastolic notch during non-gestational period. During normal pregnancy，uterine arterial vascular resistance decreases continuously from early to mid-pregnancy，and does not change much in late pregnancy. About 50% of normal pregnant women have an early diastolic notch in the uterine artery at the end of early pregnancy，which almost disappears at 24th gestational week. Uterine artery blood flow reflects the remodeling of spiral arteries by trophoblasts. In pregnancies complicated by preeclampsia（PE）and/or fetal growth restriction（FGR），blood flow resistance is usually less reduced，inducing increased uterine artery RI and PI compared to normal pregnancies. Uterine arterial blood flow can be used in early pregnancy to screen for early-onset PE and FGR，but the predictive value needs further study and it can also be used to assess FGR during second and third trimesters，but interventions for abnormal outcomes have not been proven effective. There is no high-quality evidence-based medical evidence for treatment according to uterine artery flow resistance in recurrent miscarriage.

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Role of placental blood flow ultrasonography in placenta accreta spectrum disorders. LI Yi-xin, CHEN Lian, ZHAO Yang-yu. 2022, 38(4): 406-409.  DOI: 10.19538/j.fk2022040107 Abstract ( )   Placenta accrete spectrum disorders（PAS）is an abnormal invasion of the trophoblastic tissue through the myometrium and even involves the bladder and rectum，which can lead to severe postpartum bleeding，hysterectomy and even death. Common high-risk factors include placenta previa，previous cesarean delivery，advanced maternal age. Rise in cesarean section rate has led to an increase in the incidence of PAS. According to ultrasound signs and placental blood flow examination, we can predict the risk of PAS，standardize the management of pregnant women and reduce the complications of PAS，which is of great value.

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Application of cerebroplacental ratio determined by ultrasound Doppler in obstetrics.  CHEN Hui, CHEN Hai-ning, LIANG Xu-xia. 2022, 38(4): 409-415.  DOI: 10.19538/j.fk2022040108 Abstract ( )   Cerebroplacental ratio（CPR），calculated as a simple ratio of middle cerebral artery pulsatility index and umbilical artery pulsatility index，is considered as a sensitive indicator for fetal distress and has received attention from obstetricians and sonographers in recent years. The aim of this article is to review the key evidence regarding the value of CPR in the assessment of fetal growth and in the prediction of adverse perinatal outcomes.

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Fetal heart rate monitoring and fetal ultrasonic Doppler blood flow parameters in fetal monitoring.  GENG Hui-zhen, WANG Zi-lian 2022, 38(4): 415-419.  DOI: 10.19538/j.fk2022040109 Abstract ( )   Fetal heart rate monitoring and fetal ultrasonic Doppler flow parameters are the most commonly used methods for fetal monitoring in clinical practice.These two monitoring methods have the characteristics of non-invasiveness，simple operation and high negative predictive value，making them the most important means for the evaluation of fetal intrauterine status. Fetal heart rate monitoring is widely used in prenatal and intrapartum monitoring，while ultrasonic Doppler blood flow monitoring is mainly used in prenatal fetal monitoring，and it has high predictive value in the monitoring of fetuses with growth restriction. For high-risk fetuses，fetal heart rate monitoring combined with color Doppler flow parameters can improve the predictive value of fetal hypoxia and guide clinical practice of taking effective measures to improve pregnancy outcomes.

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Value of Doppler ultrasound in diagnosis and management of complication of monochorionic twin pregnancies. WU Feng-yu, SUN Lu-ming 2022, 38(4): 420-423.  DOI: 10.19538/j.fk2022040110 Abstract ( )   Complications of monochorionic twin pregnancies result in a high risk of perinatal morbidity and mortality，and standardized prenatal monitoring and management is helpful to improve their perinatal outcomes.Doppler flow assessment is one of the important means to monitor  the complications of monochorionic twins，which included the assessment of umbilical artery，middle cerebral artery and ductus venosus. This paper discusses the standardized measurement of Doppler flow and its value in the diagnosis and management of complications of monochorionic twin pregnancies.