The role of Doppler blood flow velocimetry in multiple pregnancy

Abstract

This article focuses on Doppler velocimetry in the assessment of fetal growth, placental insufficiency, management of intrauterine growth restriction, discordant growth and twin-twin transfusion syndrome. Problems specific to multiple pregnancy such as twin reversed arterial perfusion, cord entanglement and visualization of anastomoses are also reviewed. Doppler sonography seems to be superior to other tests for early detection of placental insufficiency during surveillance of multiple pregnancies. It is suggested that Doppler sonography helps to select multiple fetuses who are at higher than normal risk, and might reduce perinatal mortality and morbidity. Fetal echocardiography may provide an accurate assessment of cardiovascular adaptation to intertwin transfusion, early recognition of deterioration and evaluation of antenatal management. In the management of the twin-twin transfusion syndrome, Doppler echocardiography and Doppler ultrasound examination of the venous circulation appear to be useful tools for improved perinatal management. Doppler sonography is an important adjunct in monitoring high-risk multiple pregnancies.