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Re: Umbilical Artery DopplerFrom: James S Smeltzer MD (gaperina@mindspring.com)Wed Jan 30 14:04:52 2002
Hi, If this is a term pregnancy, you are right. It indicates significant cephalization of blood flow, such that there is diastolic hypotension and reversal of flow. In general, however, it does not indicate actual acidosis, but a need for a high level of surveillance. It is not an automatic cesarean section. Babies with this situation can often sustain through an easy labor. I have followed babies delivered without acidosis two weeks after onset of reversed EDV. This is a clinical decision based on the gestational age and clinical setting. It helps, however, in following these cases, to be able to do a stat cesarean if the FHR tracing indicates, which it may if the fetus is exposed to labor, epidural etc. DO NOT USE DOPPLER TO TIME DELIVERY PRIOR TO TERM OR NEAR TERM. USE DOPPLER TO ADJUST THE NEED FOR OTHER METHODS OF SURVEILLANCE, e.g. continuous fetal heart rate of NST q6hrs for REDV. ;^) Jim Smeltzer, MD
At 06:21 PM 1/21/2002 -0600, you wrote:
>Wow! I thought that reversal of cord doppler flow was a "GET THE BABY
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