Doppler Diagnosis

Fetal growth restriction (FGR) is a disorder affecting the fetal development and an acknowledged risk factor for poor neonatal condition at birth and adverse outcome in the infanthood and adulthood. FGR is characterized by pathological smallness caused by an underlying functional problem, most commonly related to placental insufficiency leading to fetal hypoxia. Under these circumstances, fetal early adaptive mechanisms involve the diversion of the cardiac output preferentially in favor of the brain and the heart, while abnormal arterial and venous flow manifest in the case of further worsening of fetal hypoxia. Doppler ultrasound has become an essential tool for the diagnosis and the surveillance in FGR. In this chapter, we discuss the evidence-based role of the umbilical artery, middle cerebral artery, ductus venosus, and fetal cardiac Doppler in the diagnosis and monitoring of non-anomalous singleton fetuses with FGR of suspected placental origin.