In this webinar, Prof. Basky Thilaganathan presents clinical insights on the use of Doppler ultrasound in pregnancy, focusing on its role in identifying placental dysfunction. He states that placental disease affects approximately 1 in 5 pregnancies and is a major cause of fetal growth restriction, stillbirth, and preeclampsia.
The session begins by contrasting placental causes of poor outcomes with structural and chromosomal abnormalities, which account for only 4–5% of cases. Prof. Thilaganathan critiques current antenatal screening methods based on maternal characteristics, describing them as ineffective and outdated.
He introduces a model of placental efficiency to explain how Doppler ultrasound can detect dysfunction. The key focus is on replacing traditional checklist-based screening with algorithm-based risk prediction that incorporates Doppler indices.
The webinar covers several clinical applications of Doppler:
- Uterine artery Doppler in the first trimester to assess preeclampsia risk
- Umbilical artery and middle cerebral artery (MCA) Doppler for monitoring fetal response to placental insufficiency
- Ductus venosus Doppler in early-onset fetal growth restriction to assess cardiovascular adaptation
- Cerebroplacental ratio (CPR) in the third trimester to evaluate late-onset placental dysfunction
Prof. Thilaganathan discusses major trials such as ASPRE and TRUFFLE, which support the use of Doppler combined with biomarkers and computerized CTG to improve pregnancy outcomes and guide timing of delivery, especially before 32 weeks.
He concludes by emphasizing that Doppler ultrasound provides valuable real-time insight into placental function and fetal well-being and should be integrated into routine antenatal care.
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