Umbilical artery Sonographers, Growth restriction (EFW <P10, AC<P5 or Obstetrician, crossing centiles) Maternal & Fetal Risk factors for growth restriction (screening at Medicine 26 weeks): Subspecialists, Preeclampsia SASUOG or Fetal Hypertension Medicine Previous history Foundation Metabolic syndrome (high BMI, diabetes accredited general mellitus, hypertension) practitioner Low PAPP-A values (< 0.4 MoM) in first trimester Previously high UA RI MCA Growth restriction (EFW <P10, AC<P5 or SASUOG crossing centiles) accreditation for second opinion Increased UA RI or >32 weeks ultrasound or Red cell iso-immunization Fetal Medicine Maternal parvovirus B19 infection Foundation Complicated monochorionic twin pregnancies accreditation for (e.g. suspected or diagnosed TTTS, TAPS or obstetrical Doppler selective IUGR) evaluation Uterine artery (Preferably in T1, otherwise in T2) Fetal Medicine High risk of pre-eclampsia or growth restriction, Foundation including: accreditation for uterine artery Primigravidae Doppler evaluation Multigravidae with previous pre-eclampsia or growth restriction Metabolic syndrome (high BMI, diabetes mellitus, hypertension) Low PAPP-A values (< 0.4 MoM) in first trimester Pregnancy after ART
Umbilical artery Growth restriction (EFW <P10, AC<P5 or crossing centiles) Risk factors for growth restriction (screening at 26 weeks): Preeclampsia Hypertension Previous history Metabolic syndrome (high BMI, diabetes mellitus, hypertension) Low PAPP-A values (< 0.4 MoM) in first trimester Previously high UA RI Sonographers, Obstetrician, Maternal & Fetal Medicine Subspecialists, SASUOG or Fetal Medicine Foundation accredited general practitioner MCA Growth restriction (EFW <P10, AC<P5 or crossing centiles) Increased UA RI or >32 weeks Red cell iso-immunization Maternal parvovirus B19 infection Complicated monochorionic twin pregnancies (e.g. suspected or diagnosed TTTS, TAPS or selective IUGR) SASUOG accreditation for second opinion ultrasound or Fetal Medicine Foundation accreditation for obstetrical Doppler evaluation Uterine artery (Preferably in T1, otherwise in T2) High risk of pre-eclampsia or growth restriction, including: Primigravidae Multigravidae with previous pre-eclampsia or growth restriction Metabolic syndrome (high BMI, diabetes mellitus, hypertension) Low PAPP-A values (< 0.4 MoM) in first trimester Pregnancy after ART Fetal Medicine Foundation accreditation for uterine artery Doppler evaluation
Guidelines_for_the_obstetrical_use_of_Doppler_ultrasound_21112017_final.docx