DOPPLER SONOGRAPHY IN HIGH-GRADE MULTIPLE PREGNANCIES

From 1987 until 1992, 16 triplets and 2 quadruplets were studied by pu lsed Doppler ultrasound between 17 and 36 weeks of gestation. A resist ance index (RI) of the foetal aorta and umbilical artery above the 95t h percentile was considered pathological. Elevated RI-values of the um bilical artery as compared to the A. cerebri media were indicative of circulatory centralisation. Intrauterine growth retardation (IUGR) was found in 9 (16 %) foetuses, discordant growth occurred in 7 (39 %) pr egnancies. 41 (73 %) of 56 foetuses survived in good health. Four of 7 foetuses with pathological Doppler findings died. The three survivors were markedly retarded. Four of 6 cases of intrauterine endangered fo etuses were detected by Doppler sonography. The diagnosis of IUGR or d iscordant growth was based more frequently on pathological Doppler fin dings than on biometry and improved upon by combinations of both metho ds. Doppler sonography proved to be an important complementary method in the monitoring of high-grade multiple pregnancies.