Study of fetal doppler velocimetry versus non stress test as predictors of adverse perinatal outcome in high risk pregnancies

Hymavathi K., Prasuna P., Davuluru Sandhya Rani


Background: Pregnancy is a unique, physiologically normal event in a women’s life. Objective of this study was to compare the efficacy of the doppler velocimetry versus non stress test in relation to perinatal outcome in high risk pregnancies.

Methods: This is a prospective study conducted in the department of obstetrics and gynaecology, Narayana Medical College and Hospital. 100 women with high risk pregnancy were recruited. All were examined systematically, and Doppler velocimetry and non-stress test were done.

Results: All cases were divided into four groups based on NST and doppler velocimetry of umbilical artery and middle cerebral artery. 10% of women had abnormal doppler. Middle cerebral artery doppler abnormality was noted in 3% and CPR abnormality in 3% of women in the study group. 15% had abnormal NST. In Group A, out of 88 patients 9 had fetal compromise. In Group B, out of 5 patients all had fetal compromise. In Group C, out of 4 patients none had fetal compromise. In Group D, all 3 patients had fetal compromise. In Group D, all 3 had neonatal deaths. Average birth weights in Group A was 2.7 kg, in Group B was 2 kg, in Group C was 2.5 kg, in Group D was 1.4 kg. Two (2.2%) newborn in Group A, 4 (80%) newborns in Group B, 3 (100%) in Group had Apgar < 7 at 5 minutes. 4 (4.5%) babies in Group A, 5 (100%) babies in Group B, 3 (100%) babies in Group D were admitted in NICU. Umbilical artery doppler was found to have sensitivity 46.6%, specificity - 94%, PPV - 93%, NPV - 54%. Middle cerebral artery doppler was found to have sensitivity 73.3%, specificity - 90%, PPV - 91.6%, NPV- 69.3%.

Conclusions: In present study, highest percentage of perinatal complications and perinatal deaths were seen in groups with abnormal tests of NST and velocimetry. Group D had the worst perinatal outcome.


Doppler velocimetry, High-risk pregnancies, Perinatal complications, Non-stress test

Full Text:



Deane C, Harrington K. A practical approach to obtaining optimum doppler signals. A colour atlas of Doppler ultrasonography in obstetrics. London: Arnold. 1995;168:35-46.

Fitzgerald DE, Drumm JE. Non-invasive measurement of human fetal circulation using ultrasound: a new method. BMJ. 1977;2:1450-1.

Rao K, Sheshadri S. Fetal doppler. Asian J Obstet Gynecol. 2003;7(7):17-22.

Gagnon, Robert, Van den Hof M. The use of fetal Doppler in obstetrics. J Obstet Gynaecol Canada. 2003;25(7):601-14.

Baschat AA. Doppler application in the delivery timing of preterm growth-restricted fetus: another step in the right direction. Ultrasound Obstet Gynecol. 2004;23:111-8.

Baschat AA, Güclü S, Kush ML, Gembruch U, Weiner CP, Harman CR. Venous doppler in the prediction of acid-base status of growthrestricted fetuses with elevated placental blood flow resistance. Am J Obstet Gynecol. 2004;191:277-84.

Rizzo G, Capponi A, Talone PE, Arduini D, Romanini C. Doppler indices from inferior vena cava and ductus venosus in predicting pH and oxygen tension in umbilical blood at cordocentesis in growth-retarded fetuses. Ultrasound Obstet Gynecol. 1996;7:401-10.

Mallikarjunappa B, Harish H, Ashish SR, Pukale RS. Doppler changes in pre-eclampsia. JIMSA. 2013;26:4.

Nagar T, Sharma D, Choudhary M, Khoiwal S, Nagar RP, Pandita A. The role of uterine and umbilical arterial doppler in high-risk pregnancy: a prospective observational study from India. Clin Med Insights: Repro Health. 2015;9:CMRH-S24048.

Lakhkar BN, Rajagopal KV, Gourisankar PT. Doppler prediction of adverse perinatal outcome in PIH and IUGR. Indian J Radiol Imag. 2006;16(1):109.

Shahinaj R, Manoku N, Kroi E, Tasha I. The value of the middle cerebral to umbilical artery Doppler ratio in the prediction of neonatal outcome in patient with preeclampsia and gestational hypertension. J Prenatal Med. 2010;4(2):17.

Deshmukh A, Soni N, Gokhale S. Significance of umbilical artery doppler velocimetry in the perinatal outcome of the growth restricted fetuses. J Obstet Gynaecol India. 2010;60(1):38-43.

Komuhangi P, Byanyima RK, Kiguli-Malwadde E, Nakisige C. Umbilical artery doppler flow patterns in high-risk pregnancy and foetal outcome in Mulago hospital. Case Reports Clin Med. 2013;2(9):554.

Choudhury N, Sharma BK, Kanungo BK, Yadav R, Rahman H. Assessment of Doppler velocimetry versus nonstress test in antepartum surveillance of high-risk pregnancy. Int J Repro Contracept Obstet Gynecol. 2017;6(2):664.

Byun YJ, Kim HS, Yang JI, Kim JH, Kim HY, Chang SJ. Umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age infants. Yonsei medical journal. 2009;50(1):39-44.

Urmila S, Beena B. Triple vessel wave pattern by Doppler studies in normal and high-risk pregnancies and perinatal outcome. J Obstet Gynecol India. 2010;60(4):312-6.

Bansal A, Choudhary J, Gupta H. Role of panvessel doppler study in high risk pregnancy. Diabetes. 2015;3:6.

Prasad GV, Sarvottam J. Role of doppler study in the evaluation of intrauterine growth retardation. J Evi Med Healthcare. 2015;2(42):7266-75.

Manikyarao S, Baby Indira N, Gayathri S. Role of colour doppler in pregnancy induced hypertension; Indian J Applied Res. 2015;5(4).

Khanduri S, Parashari UC, Bashir S, Bhadury S, Bansal A. Comparison of diagnostic efficacy of umbilical artery and middle cerebral artery waveform with color Doppler study for detection of intrauterine growth restriction. The J Obstet Gynecol India. 2013;63(4):249-55.

Rajesh M, Agamya S. Role of colour doppler indices in the diagnosis of intrauterine growth retardation in high- risk pregnancies. The J Obst Gynec India 2013;63(1):37-44.

Bano S, Chaudhary V, Pande S, Mehta VL, Sharma AK. Color doppler evaluation of cerebral-umbilical pulsatility ratio and its usefulness in the diagnosis of intrauterine growth retardation and prediction of adverse perinatal outcome. Indian J Radiol Imag. 2010;20(1):20.