A RANDOMIZED CONTROLLED TRIAL OF DOPPLER ULTRASOUND VELOCIMETRY OF THE UMBILICAL ARTERY IN LOW-RISK PREGNANCIES

Objective To evaluate the effect on management and outcome of pregnanc y of routine umbilical Doppler examination in low risk populations. De sign Pragmatic randomised controlled trial. Setting Twenty centres car ing for low risk pregnant women. Participants 4187 women were randomly assigned to umbilical Doppler between 28 and 34 weeks of gestation or no routine umbilical Doppler. The women included were at low risk at 28 weeks of gestation defined by a normal ultrasonographic examination at the time of randomisation and no ses obstetric or medical complica tions during the first two trimesters of the pregnancy. Results The ge neral characteristics at inclusion were comparable for the mio groups. Performance of umbilical Doppler led to a significant increase in the number of ultrasonographic and Doppler examinations subsequently cond ucted; there were no other effects on the management of the pregnancy. There was no significant difference in fetal distress during labour ( odds ratio [OR] 0.96; 95% confidence interval [CI] 0.70-1.33). There w ere three times fewer perinatal deaths in the Doppler group (three ver sus nine), but this difference was not significant (OR 0.33; 35% CI 0. 06-1.33). Conclusion Based on this trial routine use of umbilical dopp ler for low risk pregnancy cannot be recommended. More data are needed to reach a definite conclusion of the value of routine Doppler.