{ "release_id": "c7fb95f1d15a7d13", "id": "maternal:umbilical-artery-doppler", "owner": "maternal", "kind": "technology", "slug": "umbilical-artery-doppler", "name": "Umbilical artery Doppler ultrasound", "aliases": [], "atlases": [ "maternal" ], "summary_plain": "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.", "summary_technical": "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.", "editorial_state": "draft", "last_substantive_edit": "2026-10-14", "last_evidence_check": "2026-10-14", "next_review_due": null, "identifiers": [], "navigation": { "maternal": { "life-stage": [ "pregnancy" ], "care-area": [ "fetal-development" ] } }, "payload": { "principle": "Doppler ultrasound shows the speed and direction of blood flow (MedlinePlus); in pregnancy the Cochrane review compares Doppler of the umbilical artery of the unborn baby with no Doppler or with cardiotocography. Abnormal blood flow patterns in the fetal circulation may indicate poor fetal prognosis (review background).", "strengths": [ "The Cochrane review found fewer perinatal deaths, fewer inductions of labour and fewer caesarean sections where umbilical artery Doppler was used in high-risk pregnancy, with moderate-quality evidence for these outcomes." ], "limitations": [ "The review background says false positive Doppler findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery.", "None of the evidence for the main outcomes was graded high quality, and the review found no comparative long-term follow-up of exposed babies." ], "required_infrastructure": [ "An ultrasound device with Doppler, and a trained sonographer." ] }, "content_digest": "c3cc92089f8849187f03533978e6ed80034787a8d19b2ccd73307952e51c90be", "review": { "content_digest": "c3cc92089f8849187f03533978e6ed80034787a8d19b2ccd73307952e51c90be", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-cochrane-doppler-induction-caesarean", "owner": "maternal", "subject_entity_id": "maternal:umbilical-artery-doppler", "category": "effect", "statement": "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).", "context": { "id": "maternal:ctx-cochrane-doppler-women", "label": "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_note": "Pregnancy, high risk; labour and birth", "life_stage_terms": { "maternal": [ "pregnancy", "childbirth" ] }, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not stated in the parts of the source that were read.", "eligibility": { "inclusion": [ "Randomised and quasi-randomised controlled trials of Doppler ultrasound of umbilical and fetal vessel waveforms in high-risk pregnancies, compared with no Doppler ultrasound" ], "exclusion": [ "Not stated in the parts of the source that were read." ] } }, "evidence_stage": "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)", "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.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, MAIN RESULTS, sentence 8, fragment 1 of 2", "applicability_note": "PubMed abstract.", "snapshot": { "id": "maternal:pubmed-28613398-2026-10-14", "retrieved_at": "2026-10-14T18:18:28Z", "content_hash": "a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:pubmed-10-1002-14651858-cd007529-pub4", "source_type": "publication", "title": "Fetal and umbilical Doppler ultrasound in high-risk pregnancies", "canonical_url": "https://doi.org/10.1002/14651858.CD007529.pub4", "identifiers": [ { "scheme": "doi", "value": "10.1002/14651858.CD007529.pub4", "normalized_value": "10.1002/14651858.cd007529.pub4", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "28613398", "normalized_value": "28613398", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2017-06-13", "publisher": "The Cochrane database of systematic reviews", "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.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). 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The full text and the version of record were not read.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). 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The full text and the version of record were not read.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). 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The review authors graded this evidence moderate.", "context": { "id": "maternal:ctx-cochrane-doppler-babies", "label": "Babies of women with high-risk pregnancies in trials of Doppler ultrasound (Cochrane review)", "recipient": "mixed", "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_note": "Pregnancy, high risk; follow-up to birth and the newborn period", "life_stage_terms": { "maternal": [ "pregnancy" ] }, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not stated in the parts of the source that were read.", "eligibility": { "inclusion": [ "Randomised and quasi-randomised controlled trials of Doppler ultrasound of umbilical and fetal vessel waveforms in high-risk pregnancies, compared with no Doppler ultrasound" ], "exclusion": [ "Cluster-randomised trials were eligible, but none were identified" ] } }, "evidence_stage": "synthesis", "certainty": "moderate", "certainty_method": "Cochrane review authors' own GRADE assessment for the perinatal death outcome, as stated in the abstract (moderate)", "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.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, MAIN RESULTS, sentence 1", "applicability_note": "PubMed abstract.", "snapshot": { "id": "maternal:pubmed-28613398-2026-10-14", "retrieved_at": "2026-10-14T18:18:28Z", "content_hash": "a330a2a35b807886c03bdbfdd6ae55f0b940f8336a427ad30f920e74f8c0a02f", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:pubmed-10-1002-14651858-cd007529-pub4", "source_type": "publication", "title": "Fetal and umbilical Doppler ultrasound in high-risk pregnancies", "canonical_url": "https://doi.org/10.1002/14651858.CD007529.pub4", "identifiers": [ { "scheme": "doi", "value": "10.1002/14651858.CD007529.pub4", "normalized_value": "10.1002/14651858.cd007529.pub4", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "28613398", "normalized_value": "28613398", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2017-06-13", "publisher": "The Cochrane database of systematic reviews", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. 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