Juniper Publishers: Is Obstetric Color Doppler as Helpful in Predicting Fetal Outcome as Perceived?


JUNIPER PUBLISHERS- JOURNAL OF GYNECOLOGY AND WOMEN’S HEALTH



                      Journal of Gynecology and Women’s Health-Juniper Publishers

Authored by  Som Biswas*


Abstract

Ultrasound Obstetric Color Doppler has become a routine for any high risk pregnancy nowadays. But in experience it has not been found to correlate well with fetal outcome. This article is a subjective opinion of the author regarding the same based on his vast experience in day to day obstetrics practice.
Keywords: Obstetric color doppler; Fetal outcome; High risk pregnancy

Introduction

With the invention of color Doppler it has become routine for sending high risk pregnancies for frequent color dopplers. Many articles have also been published stating that Doppler studies in high-risk pregnancies are more beneficial in the management of perinatal as well as in neonatal management [1]. But in experience it has been found in my opinion that sending patients for obstetric color Doppler which is a time consuming study just wastes precious time especially in high risk pregnancies. Most of even the high risk pregnancies like severe oligohydromnios and eclampsia and severe preeclampsia already have a poor fetal outcome confirmed clinically and by Obstetric ultrasound. To reconfirm with a Doppler is unnecessary in my opinion. Immediate decision should be taken regarding treatment rather than running diagnostic tests. Also surprisingly many of the Doppler reports of these patients come as normal, probably as a poor Doppler is generally the end stage and is not correlable with each and every type of high risk pregnancy.

Also in a busy government setup like ours where there is a huge overload of patients unnecessary tests are a waste of the taxpayers money and also tough for the resident doctors who manage everything in a government hospital. As it is patient care and satisfaction is less in these hospitals as most gynecological faculties are un attentive and all patients are managed by junior resident doctors.
In my experience, I have received normal Doppler studies for many patients with severe IUGR, oligo hydramnios, Preeclampsia. I have personally taken efforts to get the study results confirmed by senior consultants but still the reports are normal. However after timely delivery many times the fetus has died or had a poor outcome.

Also there are no confirmed studies that obstetric Doppler are completely safe for the fetus. The ever increasing amount of testing and monitoring done during a sonograph has increased the exam time to last between 20-60 minutes, exposing the fetus to longer and higher levels of ultrasound [2]. Most studies stating that ultrasound is completely safe for fetus are regarding the obstetric ultrasound and not Doppler. Also time taken for each patient is variable.

Conclusion

In my opinion Obstetric color Doppler should not be a routine for every high risk pregnancy and should be decided on a case to case basis taking clinical factors and time into account. However these are my personal opinion and further studies are required in this subject.


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