FETAL HEART-RATE ALTERATIONS AND THEIR OBSTETRICAL MANAGEMENT - THE USEFULNESS OF DOPPLER ULTRASOUND INVESTIGATIONS

In a study of 30 cases with moderate or serious foetal heart rate alterations, we examined the influence of Doppler ultrasound on our obstetrical management. Normal results of Doppler umbilical artery flow velocity waveform analysis would allow us in 22 of 24 cases, to continue the pregnancy under usual control. Only in two cases with moderate foetal heart rate alterations, absence of labour and a normal Doppler result, Caesarean section was necessary because of foetal distress. A pathological Doppler result was found in six cases with intrauterine growth retardation. These risks were not known prior to the patients hospitalisation. Surprisingly, we found only moderate foetal heart rate alterations in these cases. Without any further control of the foetal heart rate, we decided to perform Caesarean section immediately after the Doppler investigation. We are of the opinion, that Doppler ultrasound could be very useful in obstetrical management to decide, if the pregnancy must be ended or could possibly be continued in cases of premature birth.