Danny Tucker
Quiz by , created more than 1 year ago

By Dr Danny Tucker, Director of Obtetrics & Gynaecology, Townsville Hospital, Queensland, Australia. Quiz based upon the following review article: http://bit.ly/dopplerus

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Danny Tucker
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Doppler ultrasound in obstetrics

Question 1 of 7

1

Doppler ultrasonography has an established role in monitoring of the following pregnancy complications

Select one or more of the following:

  • Intrauterine fetal growth restriction

  • Rhesus disease

  • Twin-to-twin transfusion syndrome

  • Gestational diabetes

  • Fetal macrosomia

Explanation

Question 2 of 7

1

Which of the following is true regarding use of umbilical artery (UA) doppler in IUGR pregnancies?

Select one of the following:

  • Abnormal UA doppler directly correlates with a lower number of placental arteries per high power field

  • Abnormal UA doppler predicts fetal compromise with a lead time of 3 days after diagnosis

  • Diagnosis of abnormal UA doppler ultrasound affords time for useful interventions to be instituted to prolong pregnancy

  • Serial UA dopplers should be used from 32 weeks in high risk pregnancies

  • Absent end-diastolic flow in the umbilical artery is a trigger for delivery in a fetus <32 weeks

Explanation

Question 3 of 7

1

There is good RCT evidence for the use of fetal venous dopplers in the management of IUGR

Select one of the following:

  • True
  • False

Explanation

Question 4 of 7

1

Regarding the Middle Cerebral Artery (MCA) doppler in IUGR, which of the following are true?

Select one or more of the following:

  • MCA doppler assessment is of similar efficacy in both IUGR-affected pregnancies and the prediction of fetal anaemia in Rhesus isoimmunisation

  • In IUGR there is 'brain sparing' effect, leading to an increased diastolic flow, hence reduction in PI.

  • The MCA PI/ UA PI ratio (cerebro-placental ratio) is more sensitive than either measurement in isolation

  • MCA doppler is equally useful in both early and late-onset IUGR

Explanation

Question 5 of 7

1

The role of the Ductus Venosus in IUGR. Select the true answers.

Select one or more of the following:

  • DV doppler acts as a marker of cardiovascular deterioration

  • Absence or reversal of A-wave in early IUGR is a strong predictor of fetal acidaemia

  • There are clear RCT data and consensus around use of DV and timing of delivery of the IUGR fetus

Explanation

Question 6 of 7

1

Uterine artery doppler at 20-24 weeks gestation in low risk populations has a high predictive value for IUGR/pre-eclampsia

Select one of the following:

  • True
  • False

Explanation

Question 7 of 7

1

Finally, which of the following are true?

Select one or more of the following:

  • Aortic isthmus doppler abnormalities may precede DV changes, often by one week

  • Umbilical vein doppler abnormalities may predict right heart failure and myocardial hypoxia

  • MCA PSV can predict the existance of moderate to severe fetal anaemia with a sensitivity of 100% and false positive rate of 12%

Explanation

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