COMPLETE FETAL DOPPLER DIAGNOSTIC FINDINGS
1 NORMAL FETAL CIRCULATION
📄 UA PI normal + MCA PI normal → CPR normal.
Normal fetoplacental and cerebral circulation.
No Doppler evidence of fetal compromise.
2 UTEROPLACENTAL DYSFUNCTION
📄 Uterine artery PI ↑ with normal UA & MCA
Impaired placentation.
Increased risk of preeclampsia / FGR.
3 PLACENTAL INSUFFICIENCY
📄 UA PI ↑ + MCA PI normal → CPR ↓
Increased placental vascular resistance
4 FETAL HYPOXIA (BRAIN-SPARING EFFECT)
📄 UA PI ↑ + MCA PI ↓ → CPR ↓
Cerebral vasodilatation noted
Adaptive fetal response to hypoxia
5 LATE-ONSET FGR
📄 UA PI normal + MCA PI ↓ → CPR ↓
Late-onset placental dysfunction
Cerebral redistribution with preserved UA flow
6 EARLY-ONSET FGR
📄 UA PI ↑ + MCA PI normal / ↓ → CPR ↓
Placental insufficiency–dominant pattern
7 SEVERE PLACENTAL INSUFFICIENCY
📄 UA AEDF → Critical placental resistance
📄 UA REDF → Severe placental failure
8 ADVANCED FETAL COMPROMISE
📄 UA AEDF / REDF + MCA PI ↓
Abnormal ductus venosus waveform
Absent / reversed DV A-wave
High risk of fetal acidosis / IUFD
9 TERMINAL FETAL DECOMPENSATION
📄 Pulsatile umbilical venous flow
📄 Combined UA + DV + UV abnormalities
10 FETAL ANEMIA
📄 MCA PSV >1.29 MoM → Mild anemia
📄 MCA PSV >1.5 MoM → Moderate anemia
📄 MCA PSV >1.55 MoM → Severe anemia
11 FETAL POLYCYTHEMIA
📄 MCA PSV <1.0 MoM
Increased blood viscosity
12 TAPS (TWIN ANEMIA–POLYCYTHEMIA SEQUENCE)
📄 Donor twin: MCA PSV >1.5 MoM
📄 Recipient twin: MCA PSV <1.0 MoM
13 TTTS (TWIN-TO-TWIN TRANSFUSION SYNDROME)
📄 Donor: UA PI ↑ + oligohydramnios
📄 Recipient: Cardiac strain + abnormal DV
14 SELECTIVE FGR (TWINS)
📄 Type I – Persistent positive UA EDF
📄 Type II – Persistent AEDF / REDF
📄 Type III – Intermittent AEDF
15 FETAL CARDIAC FAILURE / HYDROPS
📄 Abnormal DV + UV pulsatility
Elevated central venous pressure
16 OVERALL DOPPLER PROGNOSIS
📄 Favorable fetal hemodynamics
📄 Compromised fetal circulation
📄 Severe fetal compromise – urgent intervention advised
16 CARDIAC FUNCTION & CONGENITAL HEART DISEASE (DOPPLER CORRELATION)
📄 Abnormal ductus venosus with normal UA & MCA
Suggestive of primary fetal cardiac dysfunction.
Placental cause less likely.
📄 Absent / reversed DV A-wave with preserved CPR
Indicative of impaired cardiac preload or myocardial dysfunction.
Underlying congenital heart disease cannot be excluded.
📄 Persistent abnormal DV despite normal placental Doppler
Favors cardiac etiology over placental insufficiency.
Targeted fetal echocardiography advised.
17 SPECIFIC CONGENITAL CARDIAC ANOMALY – SUGGESTIVE DOPPLER PATTERNS
📄 Severe tricuspid regurgitation + dilated right atrium ± abnormal DV
Suggestive of Ebstein anomaly.
Right-sided volume overload suspected.
📄 Moderate TR with relatively preserved CPR
May indicate tricuspid valve dysplasia.
Structural atrioventricular valve abnormality suspected.
📄 Abnormal DV waveform with raised right heart pressures
Suggestive of pulmonary stenosis / RV outflow tract obstruction.
Increased right ventricular afterload.
📄 Abnormal DV + UV pulsatility with normal MCA PSV
Cardiac failure rather than fetal anemia likely.
Consider cardiomyopathy or complex congenital heart disease.
📄 Abnormal DV + abnormal CPR
Combined placental and cardiac pathology suspected.
Poor prognostic indicator.
18 CARDIAC RISK STRATIFICATION (DOPPLER-BASED)
📄 Low cardiac risk: Normal DV waveform, no TR, normal CPR.
📄 Intermediate cardiac risk: Isolated TR or mildly abnormal DV with normal placental Doppler.
📄 High cardiac risk: Abnormal DV ± TR ± UV pulsatility.
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