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a Chapter 24 Doppler Velocimetry for Fetal Surveillance: Adverse Perinatal Outcome and Fetal Hypoxia 373
Doppler velocimetry shows mostly similar and often
superior efficacy. Furthermore, progressive fetal deterioration
manifests in sequential abnormalities of the
various fetal assessment parameters, starting with
middle cerebral artery vasodilation and eventual progression
to disappearance of the fetal heart rate variability,
late deceleration, and the absence or reversal of
the end-diastolic velocity in the umbilical artery. Evidently,
no single testing modality should be regarded
as the exclusive choice for fetal surveillance, as these
tests reveal different aspects of fetal pathophysiology,
often in a complementary manner. Clearly, more
work is needed to determine the optimal integration
of the various surveillance methods for improving
perinatal outcome in a cost-effective manner.
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