# Umbilical artery Doppler ultrasound Technology · id `maternal:umbilical-artery-doppler` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Pregnancy Browse, care area: The baby before birth ## In plain language A scan of the blood flow in the cord that carries blood to and from the baby. In high-risk pregnancies a Cochrane review linked its use with fewer baby deaths around birth, and with fewer inductions of labour and caesarean births, based on moderate-quality evidence. It found no clear difference for stillbirths alone. The review found no follow-up of these babies later in childhood. ## Technical summary A Doppler mode of pregnancy ultrasound. The Cochrane review (PMID 28613398; 19 trials, 10,667 women, searched to March 2017) compared umbilical artery Doppler with no Doppler or cardiotocography in high-risk pregnancies defined by the trials. The SMFM consult (PMID 32407785) recommends serial umbilical artery Doppler once fetal growth restriction is diagnosed. Both are shown as claims; the review population is high-risk pregnancy and not only growth restriction. ## Claims, with the population each applies to ## Context: Babies of women with high-risk pregnancies in trials of Doppler ultrasound (Cochrane review) Recipient: Mixed recipients; Population: Fetuses and babies of women with high-risk pregnancies in 19 randomised and quasi-randomised trials that compared Doppler ultrasound of umbilical and fetal vessels with no Doppler ultrasound. The abstract does not define high risk beyond the trials own definitions. Outcomes in this context (perinatal deaths and stillbirths) are counted in babies and include deaths before and after birth.; Care setting: Antenatal care in the included trials; setting not described in the abstract; Geography: Not stated in the abstract; Life stage: Pregnancy, high risk; follow-up to birth and the newborn period; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. ### A Cochrane review of 19 trials involving 10,667 women in high-risk pregnancies found that Doppler ultrasound of the umbilical artery was associated with fewer perinatal deaths than no Doppler or cardiotocography: risk ratio 0.71 (95% confidence interval 0.52 to 0.98; 16 studies, 10,225 babies), 1.2% versus 1.7%, number needed to treat 203 (95% CI 103 to 4352). The review authors graded this evidence moderate. - Category: Effect - Evidence stage: Evidence synthesis - Certainty: Moderate certainty (method: Cochrane review authors' own GRADE assessment for the perinatal death outcome, as stated in the abstract (moderate)) - Applies to: Recipient: Mixed recipients; Population: Fetuses and babies of women with high-risk pregnancies in 19 randomised and quasi-randomised trials that compared Doppler ultrasound of umbilical and fetal vessels with no Doppler ultrasound. The abstract does not define high risk beyond the trials own definitions. Outcomes in this context (perinatal deaths and stillbirths) are counted in babies and include deaths before and after birth.; Care setting: Antenatal care in the included trials; setting not described in the abstract; Geography: Not stated in the abstract; Life stage: Pregnancy, high risk; follow-up to birth and the newborn period; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. - Limitations: High-risk pregnancy is defined by the included trials and is not limited to growth restriction; the abstract does not say how many had growth restriction. None of the evidence for the main outcomes was graded high; risk of bias was hard to assess because of incomplete reporting, and evidence was downgraded for missing information on trial methods, imprecision and heterogeneity. The upper end of the interval (0.98) is close to no difference. The same review found no clear difference for stillbirths alone (see the stillbirth claim) and reports no comparative long-term follow-up of babies exposed to Doppler ultrasound in these pregnancies. The searches ran to 31 March 2017. Only the abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 2. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 3. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 4. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 4. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 5, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 5. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 5, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 6. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 6, fragment 2 of 4. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 7. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 6, fragment 3 of 4. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 8. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 6, fragment 4 of 4. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 9. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 9, fragment 1 of 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 10. Background: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, SEARCH METHODS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: Frames the population or setting. PubMed abstract. 11. Background: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, SELECTION CRITERIA, sentence 1, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: Frames the population or setting. PubMed abstract. 12. Background: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, SELECTION CRITERIA, sentence 1, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: Frames the population or setting. PubMed abstract. ### In the same Cochrane review, the result for stillbirths was consistent with the overall rate of perinatal deaths, but there was no clear difference between groups for this outcome: risk ratio 0.65 (95% CI 0.41 to 1.04; 15 studies, 9560 babies). The review authors graded this evidence low. - Category: Effect - Evidence stage: Evidence synthesis - Certainty: Low certainty (method: Cochrane review authors' own GRADE assessment for the stillbirth outcome, as stated in the abstract (low)) - Applies to: Recipient: Mixed recipients; Population: Fetuses and babies of women with high-risk pregnancies in 19 randomised and quasi-randomised trials that compared Doppler ultrasound of umbilical and fetal vessels with no Doppler ultrasound. The abstract does not define high risk beyond the trials own definitions. Outcomes in this context (perinatal deaths and stillbirths) are counted in babies and include deaths before and after birth.; Care setting: Antenatal care in the included trials; setting not described in the abstract; Geography: Not stated in the abstract; Life stage: Pregnancy, high risk; follow-up to birth and the newborn period; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. - Limitations: The confidence interval includes no difference, so this outcome does not show a benefit on its own. The review reports no comparative long-term follow-up of babies exposed to Doppler ultrasound in these pregnancies. Only the abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 7, fragment 1 of 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 2. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 7, fragment 2 of 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 3. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 7, fragment 3 of 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 4. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 9, fragment 1 of 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. ## Context: Women with high-risk pregnancies in trials of Doppler ultrasound (Cochrane review) Recipient: Maternal; Population: Women with high-risk pregnancies in the trials of Doppler ultrasound reviewed by Cochrane. Outcomes in this context (induction of labour, caesarean section, operative vaginal birth) are counted in women.; Care setting: Antenatal care and birth in the included trials; setting not described in the abstract; Geography: Not stated in the abstract; Life stage: Pregnancy, high risk; labour and birth; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. ### In the Cochrane review of Doppler ultrasound in high-risk pregnancies, fewer inductions of labour were reported where Doppler was used (average risk ratio 0.89, 95% CI 0.80 to 0.99; 10 studies, 5633 women; random-effects) and fewer caesarean sections (risk ratio 0.90, 95% CI 0.84 to 0.97; 14 studies, 7918 women). The review authors graded both moderate. There was no difference in operative vaginal births (risk ratio 0.95, 95% CI 0.80 to 1.14; four studies, 2813 women). - Category: Effect - Evidence stage: Evidence synthesis - Certainty: Moderate certainty (method: Cochrane review authors' own GRADE assessment for the induction of labour and caesarean section outcomes, as stated in the abstract (moderate)) - Applies to: Recipient: Maternal; Population: Women with high-risk pregnancies in the trials of Doppler ultrasound reviewed by Cochrane. Outcomes in this context (induction of labour, caesarean section, operative vaginal birth) are counted in women.; Care setting: Antenatal care and birth in the included trials; setting not described in the abstract; Geography: Not stated in the abstract; Life stage: Pregnancy, high risk; labour and birth; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. - Limitations: These outcomes are counted in women, not babies. The upper end of the induction interval is 0.99. High-risk pregnancy is defined by the included trials and is not limited to growth restriction. Only the abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 8, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 2. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 8, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. 3. Supports: Fetal and umbilical Doppler ultrasound in high-risk pregnancies (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN RESULTS, sentence 9, fragment 2 of 3. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f. How it applies: PubMed abstract. ## Context: Fetuses with diagnosed fetal growth restriction, as addressed by SMFM Consult Series #52 Recipient: Fetal; Population: Fetuses of pregnancies in which fetal growth restriction has been diagnosed (an ultrasonographic estimated fetal weight or abdominal circumference below the 10th percentile for gestational age, per the guideline).; Care setting: Prenatal care; setting not stated in the abstract; Geography: Not stated in the abstract (SMFM is a US society); Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. ### The Society for Maternal-Fetal Medicine (Consult Series #52) recommends that once fetal growth restriction is diagnosed, serial umbilical artery Doppler assessment be performed to assess for deterioration (the guideline's own rating is GRADE 1C). - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Fetal; Population: Fetuses of pregnancies in which fetal growth restriction has been diagnosed (an ultrasonographic estimated fetal weight or abdominal circumference below the 10th percentile for gestational age, per the guideline).; Care setting: Prenatal care; setting not stated in the abstract; Geography: Not stated in the abstract (SMFM is a US society); Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not stated in the parts of the source that were read. - Limitations: This is one recommendation from a long list in the same consult. The rating is the guideline authors' and is shown as they state it. The abstract also suggests that Doppler of the ductus venosus, middle cerebral artery or uterine artery not be used for routine management of fetal growth restriction (GRADE 2B). Only the abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, sentence 5, fragment 12 of 32. Retrieved 2026-10-14T18:18:29Z. Source state: Current. Snapshot hash: 46146a6010bb229ca5fd35bacf5da7650a106f68c1ffe3d41d8515bb71aa00c4. How it applies: PubMed abstract. 2. Supports: Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, sentence 5, fragment 13 of 32. Retrieved 2026-10-14T18:18:29Z. Source state: Current. Snapshot hash: 46146a6010bb229ca5fd35bacf5da7650a106f68c1ffe3d41d8515bb71aa00c4. How it applies: PubMed abstract. 3. Supports: Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: ArticleTitle. Retrieved 2026-10-14T18:18:29Z. Source state: Current. Snapshot hash: 46146a6010bb229ca5fd35bacf5da7650a106f68c1ffe3d41d8515bb71aa00c4. How it applies: PubMed abstract. 4. Background: Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, sentence 5, fragment 2 of 32. Retrieved 2026-10-14T18:18:29Z. Source state: Current. Snapshot hash: 46146a6010bb229ca5fd35bacf5da7650a106f68c1ffe3d41d8515bb71aa00c4. How it applies: Frames the population or setting. PubMed abstract. ## Connected pages - Cochrane 2017: effect of Doppler in high-risk pregnancies in general; the review does not give the share with growth restriction: Fetal growth restriction (fetus) (`maternal:fetal-growth-restriction`) [a claim, not a settled fact; see claim `maternal:claim-cochrane-doppler-perinatal-death` and its context] - SMFM recommends serial umbilical artery Doppler once growth restriction is diagnosed: Fetal growth restriction (fetus) (`maternal:fetal-growth-restriction`) [a claim, not a settled fact; see claim `maternal:claim-smfm-serial-uad` and its context] - A Doppler mode of pregnancy ultrasound: Pregnancy ultrasound (`maternal:obstetric-ultrasound`) - Filed under this front: Imaging and monitoring (`maternal:front-imaging-and-monitoring`) ## Provenance Content hash: c3cc92089f8849187f03533978e6ed80034787a8d19b2ccd73307952e51c90be Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14