DOPPLER ULTRASOUND IN MULTIPLE PREGNANCIES

This chapter aims to provide a current review of the use of Doppler ul trasound in the management of multiple pregnancies. OVID and Medline s earches were undertaken. Randomized controlled trials, where available , were assessed by the Cochrane Review Manager (RevMan-version 3.0). T he specific multiple pregnancy problems of fetal growth restriction (F GR), twin reversed arterial perfusion sequence and twin-twin transfusi on syndrome (TTTS) were also reviewed. Historically, controlled and ra ndomized controlled trials show a promising reduction in perinatal mor tality in twin pregnancies where Doppler ultrasound is used. However, the numbers are small and Further trials are recommended. In those twi n pregnancies in which there is FCR as a result of placental dysfuncti on, Doppler ultrasonography will show intertwin discordancy. In those twin pairs where development is complicated by TTTS, there is often di scordant fetal size, with concordant fetal Doppler results. Thus Doppl er ultrasound appears to be useful in the management of twin pregnanci es and in delineating those complicated by FGR and TTTS.