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A randomised controlled trial of Doppler ultrasound velocimetry of the umbilical artery in low risk pregnancies
Publication year - 1997
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1997.tb11492.x
Subject(s) - medicine , obstetrics , umbilical artery , confidence interval , pregnancy , odds ratio , gestation , randomized controlled trial , surgery , biology , genetics
Objective To evaluate the effect on management and outcome of pregnancy of routine umbilical Doppler examination in low risk populations. Design Pragmatic randomised controlled trial. Setting Twenty centres caring for low risk pregnant women. Participants 4187 women were randomly assigned to umbilical Doppler between 28 and 34 weeks of gestation or no routine umbilical Doppler. The women included were at low risk at 28 weeks of gestation denned by a normal ultrasonographic examination at the time of randomisation and no obstetric or medical complications during the first two trimesters of the pregnancy. Results The general characteristics at inclusion were comparable for the two groups. Performance of umbilical Doppler led to a significant increase in the number of ultrasonographic and Doppler examinations subsequently conducted; there were no other effects on the management of the pregnancy. There was no significant difference in fetal distress during labour (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.70–1.33). There were three times fewer perinatal deaths in the Doppler group (three versus nine), but this difference was not significant (OR 0.33; 95% CI 0.06–1.33). Conclusion Based on this trial routine use of umbilical doppler for low risk pregnancy cannot be recommended. More data are needed to reach a definite conclusion of the value of routine Doppler.