{"id":10402,"date":"2020-08-04t21:16:58","date_gmt":"2020-08-04t11:16:58","guid":{"rendered":"\/\/www.iolishoes.com\/?page_id=10402"},"modified":"2024-04-18t23:08:22","modified_gmt":"2024-04-18t13:08:22","slug":"obstetric-dopplers","status":"publish","type":"page","link":"\/\/www.iolishoes.com\/obstetric-dopplers\/","title":{"rendered":"obstetric dopplers"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"10402\" class=\"elementor elementor-10402\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4a3838b6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4a3838b6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3c98f3dc\" data-id=\"3c98f3dc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-78453d76 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"78453d76\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-378e21b0\" data-id=\"378e21b0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-649df78d elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"649df78d\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-67e32358 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"67e32358\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-72e01bf4\" data-id=\"72e01bf4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5165a322 elementor-widget elementor-widget-text-editor\" data-id=\"5165a322\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>we would like to acknowledge ms. sarah dowthwaite for providing invaluable\u00a0 information for this section.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f6d9ca7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f6d9ca7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-55a16ba1\" data-id=\"55a16ba1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5cb970f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"5cb970f\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bd43284 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bd43284\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0182574\" data-id=\"0182574\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-5e8889c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5e8889c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-a53f17f\" data-id=\"a53f17f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0d2abfe elementor-widget elementor-widget-image\" data-id=\"0d2abfe\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"610\" height=\"694\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/06\/fetal-cord-circulation-schematic-2.png\" class=\"attachment-large size-large wp-image-20517\" alt=\"a schematic of the foetal circulation.\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/06\/fetal-cord-circulation-schematic-2.png 610w, \/\/www.iolishoes.com\/wp-content\/uploads\/2021\/06\/fetal-cord-circulation-schematic-2-264x300.png 264w\" sizes=\"(max-width: 610px) 100vw, 610px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-212dd51\" data-id=\"212dd51\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0677ce5 elementor-widget elementor-widget-text-editor\" data-id=\"0677ce5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>oxygenated, nutrient rich blood placental blood enters the foetus via the umbilical vein.<\/li><li>the umbilical vein joins the portal venous system in the liver, some umbilical blood is shunted directly to the ivc and right heart via ductus venosus.<\/li><li>blood from the right heart pumps to the lungs through the pumonary artery. however it is already oxygenated so is bypassed through foramen ovale (right atrium to left atrium) and ductus arteriosus (pulmonary artery to aortic arch).<\/li><li>foetal blood returns to the placenta from the iliac arteries into the umbilical arteries.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9cb8c7b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9cb8c7b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-041523f\" data-id=\"041523f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-458bb47 elementor-widget elementor-widget-text-editor\" data-id=\"458bb47\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>for a great explanation about the fetoplacental circulation pre and post partum, the following 5 minute video is extremely useful in assisting ultrasound practitioners understand the direction of blood flow.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3c2ef2de elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3c2ef2de\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3fdfd311\" data-id=\"3fdfd311\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3f29169e elementor-grid-1 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"3f29169e\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-3f29169e\" href=\"https:\/\/youtu.be\/hvbu9hhtkd4?si=nkv3fko0odn2kdt4\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.ytimg.com\/vi\/hvbu9hhtkd4\/hqdefault.jpg\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tfetal circulation\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\t by lisa mccabe, for openpediatrics\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-69789d0c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"69789d0c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3ac61681\" data-id=\"3ac61681\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-28a4b0ef elementor-widget elementor-widget-text-editor\" data-id=\"28a4b0ef\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-size: 14pt;\"><b>fetoplacental circulation doppler<\/b><\/span><\/p><p>it is vitally important to minimise any measurement errors in obstetric doppler to ensure it is accurate and reproducible.<\/p><p>measurements include:<\/p><ul><li>peak systolic velocity (psv)<\/li><li>end diastolic velocity (edv)<\/li><li>pulsatility index (pi) (peak systolic velocity &#8211; end diastolic velocity)\/ time averaged velocity<\/li><li>resistive index (ri)<\/li><li>systolic\/ diastolic velocity ratio (s\/d)<\/li><\/ul><p><span style=\"font-size: 14pt;\"><b>tips to improve accuracy<\/b><\/span><\/p><ul><li>measurements obtained during absence of fetal breathing and body movements. may need a maternal breath hold<\/li><li>optimal insonation is complete alignment with the bloodflow (0deg angle)<\/li><li>small doppler gate &#8211; approximately the width of the vessel being insonated<\/li><li>vessel wall filter set to low 30-60hz -eliminates the noise from the vessel walls<\/li><li>horizontal sweep shows 4-6 cardiac cycles<\/li><li>scale (prf) adjusted to the vessel being studied &#8211; waveform fills at least 75% of the screen<\/li><\/ul><div><span style=\"color: #747474; font-family: 'open sans', sans-serif; font-size: 14pt;\"><b>distinguishing between sga and fgr\/iugr<\/b><\/span><br \/><span style=\"color: #747474; font-family: 'open sans', sans-serif; font-size: 14pt;\"><b><br \/><\/b><\/span><\/div><div><span style=\"color: #747474; font-family: 'open sans', sans-serif; font-size: 14pt;\"><b><u>small for gestational age (sga)<\/u><\/b><\/span><\/div><div><ul><li>constitutionally small<\/li><li>fetal size and weight at birth are less than expected<\/li><li>estimated fetal weight (efw) less than the 10th centile<\/li><li>fetal growth appropriate for parental size and ethnicity<\/li><li>usually normal placental function<\/li><li>other causes include chromosomal or intrauterine infections<\/li><\/ul><p><strong><span style=\"font-size: 14pt;\"><u>fetal growth restriction\/intrauterine growth restriction (fgr\/iugr)<\/u><\/span><\/strong><\/p><ul><li>decrease in fetal growth prevents fetus from reaching full growth potential<\/li><li>placental insufficiency is the leading cause<\/li><li>other causes: infection, aneuploidy, structural anomaly, maternal disease\/smoking<\/li><li>adaptive changes take place in placenta and fetus<\/li><li>monitoring is vital to time delivery<\/li><\/ul><div><span style=\"color: #747474; font-family: open sans, sans-serif;\"><a href=\"https:\/\/videos-fms.jwpsrv.com\/0_5f2a4816_0x407a2d0a9c9d90d9e2a767d03a6c6821d7d0c989\/content\/conversions\/z0sjgr1u\/videos\/g4syn8va-24597532.mp4\">https:\/\/videos-fms.jwpsrv.com\/0_5f2a4816_0x407a2d0a9c9d90d9e2a767d03a6c6821d7d0c989\/content\/conversions\/z0sjgr1u\/videos\/g4syn8va-24597532.mp4<\/a><br \/><\/span><\/div><\/div><div>\u00a0<\/div><div>\u00a0<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-48d0785 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"48d0785\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-384fe9e\" data-id=\"384fe9e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-87bb6be elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"87bb6be\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-56c7cd0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"56c7cd0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d169d5a\" data-id=\"d169d5a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-de00a4b elementor-widget elementor-widget-heading\" data-id=\"de00a4b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"umbilical_cord_anatomy\"><\/span>umbilical cord anatomy<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-559dcbe5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"559dcbe5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4bbbbf77\" data-id=\"4bbbbf77\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-17f35d78 elementor-widget elementor-widget-text-editor\" data-id=\"17f35d78\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>there are initially four umbilical vessels &#8211; 2 arteries and 2 veins<\/li><li>typically the right umbilical vein atrophies to leave a 3 vessel cord<\/li><li>despite being extremely flexible , the cord protects it\u2019s vessels from kinking or rupture with whartons jelly and collagen fibres.<\/li><li>uas wrap around uv about 0.5 coils\/cm.<\/li><li>cord length varies &#8211; range of 35-70cm at birth.<\/li><li>normal cord diameter is less than 2cm.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-29a66c8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"29a66c8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ab1584c\" data-id=\"ab1584c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e573bec elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"e573bec\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1bee4e19 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1bee4e19\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6039637a\" data-id=\"6039637a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7dcaf32a elementor-widget elementor-widget-heading\" data-id=\"7dcaf32a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"umbilical_artery_ua\"><\/span>umbilical artery (ua)<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6adbd0f0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6adbd0f0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6d5d098\" data-id=\"6d5d098\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-19ba22bc elementor-widget elementor-widget-text-editor\" data-id=\"19ba22bc\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"indications_for_scanning_the_umbilical_artery\"><\/span>indications for scanning the umbilical artery<span class=\"ez-toc-section-end\"><\/span><\/h3><div><p><b>provides information on the fetal side of the placenta<\/b><\/p><ul><li>suspected or known sga<\/li><li>ac less than the 5th centile<\/li><li>discrepancy between the hc and ac<\/li><li>efw less than the 10th percentile<\/li><li>decreased fetal movements<\/li><li>maternal hypertensive disorders- preeclampsia<\/li><li>indicator for cord pathology<\/li><\/ul><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5f685da7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5f685da7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-27f4a269\" data-id=\"27f4a269\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-32c8d968 elementor-widget elementor-widget-text-editor\" data-id=\"32c8d968\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"scanning_technique_and_equipment_setup\"><\/span>scanning technique and equipment setup<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>measure during fetal inactivity.<\/li><li>identify free loop of cord on colour doppler<\/li><li>high scale (prf) to reduce aliasing<\/li><li>most accurate doppler angle= 0 degrees<\/li><li>doppler gate 2-5mm<\/li><li>optimise doppler baseline and prf to get a large waveform<\/li><li>5 consecutive waveforms recorded<\/li><li>report the <u><b>best <\/b><\/u>measurement out of three taken, <u><b>not <\/b><\/u>an average.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3729d14b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3729d14b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3ac506d3\" data-id=\"3ac506d3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-40e02a81 elementor-widget elementor-widget-text-editor\" data-id=\"40e02a81\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><span class=\"ez-toc-section\" id=\"normal_%e2%80%93_umbilical_artery\"><\/span><em><strong><span style=\"color: #00ccff;\">normal &#8211; umbilical artery<\/span><\/strong><\/em><span class=\"ez-toc-section-end\"><\/span><\/h4><div><span style=\"color: #00ccff;\">\u00a0<\/span><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-44295a7e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"44295a7e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-51cd6f3a\" data-id=\"51cd6f3a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-66f09ab8 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"66f09ab8\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-acc3366 elementor-widget elementor-widget-text-editor\" data-id=\"acc3366\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>umbilical artery pulsatility index (pi)<\/p><p>peak systolic velocity minus diastolic velocity divided by the mean velocity<\/p><p>pi=psv-dv\/mv<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-42dcc2c6\" data-id=\"42dcc2c6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f136f51 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f136f51\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bc50946\" data-id=\"bc50946\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-64b1fe5 elementor-widget elementor-widget-text-editor\" data-id=\"64b1fe5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><span class=\"ez-toc-section\" id=\"pathology_%e2%80%93_umbilical_artery\"><\/span><em><strong><span style=\"color: #00ccff;\">pathology &#8211; umbilical artery<\/span><\/strong><\/em><span class=\"ez-toc-section-end\"><\/span><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-60d9ca84 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"60d9ca84\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-73c4a03a\" data-id=\"73c4a03a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c250e97 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"c250e97\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-11d1c964 elementor-widget elementor-widget-text-editor\" data-id=\"11d1c964\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>there should not be any reversal of blood in diastole.<\/p><p>the sd ratio , pi and ri should be assessed to determine if there is increased resistance.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-705a3bb\" data-id=\"705a3bb\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b0318c5 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"1b0318c5\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6e4de9d7 elementor-widget elementor-widget-text-editor\" data-id=\"6e4de9d7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>this mother had pregnancy induced hypertension. this fetus was 23 weeks gestation ; growth restricted with reversal of the umbilical artery diastolic flow. there was fetal adaptation with cerebral redistribution. with these findings the fetus is at risk of premature delivery and a poor diagnosis.<\/p><p>\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-236d5703 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"236d5703\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-75ab9699\" data-id=\"75ab9699\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5707cb00 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"5707cb00\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-781c37c4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"781c37c4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-73e6bf94\" data-id=\"73e6bf94\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8c8ce7c elementor-widget elementor-widget-heading\" data-id=\"8c8ce7c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"middle_cerebral_artery_mca\"><\/span>middle cerebral artery (mca)<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-11789515 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"11789515\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2fd0b661\" data-id=\"2fd0b661\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-47aab082 elementor-widget elementor-widget-text-editor\" data-id=\"47aab082\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"role_of_ultrasound_indications\"><\/span>role of ultrasound \/indications<span class=\"ez-toc-section-end\"><\/span><\/h3><h3><span class=\"ez-toc-section\" id=\"mca_peak_systolic_velocity\"><\/span><em style=\"font-size: 16px;\"><b>mca peak systolic velocity<\/b><\/em><span class=\"ez-toc-section-end\"><\/span><\/h3><p><b>maternal-fetal <\/b><b>isoimmunisation<\/b><\/p><ul><li>mum and baby with different blood types, mum\u2019s immune system produces antibodies that pass back through placenta and attack baby\u2019s red blood cells.<\/li><\/ul><p><b>suspicion of fetal <\/b><b>anaemia<\/b><\/p><ul><li>could be due to isoimmunisation, infection,syndromes, placental tumours , sacrococcygeal teratoma<\/li><li>severe anaemia &#8211; the heart tries to overcome inadequate number or quality of red blood cells so pumps harder and can lead to heart failure<\/li><\/ul><p><b>anaemia due to <\/b><b>feto<\/b><b> maternal <\/b><b>haemorrhage<\/b><\/p><ul><li>most common antenatal presentation is decreased fetal activity or persistent maternal perception of decreased fetal movements.<\/li><li>accidental trauma to the abdomen and uterus can lead to an acute bleed from the fetal chorionic villi into the maternal circulation.<\/li><li>placental abruption<\/li><\/ul><p><b>unexplained hydrops &#8211; severe <\/b><b>oedema<\/b><b> of the baby<\/b><\/p><ul><li>immune hydrops : mum\u2019s immune system causes a breakdown in baby\u2019s red blood cells.<\/li><li>non immune hydrops : more common . diseases or complications interfere with baby\u2019s ability to manage fluid.<\/li><\/ul><p><b>mcda twins with suspicion of ttts or taps<\/b><\/p><ul><li>twin to twin transfusion syndrome (ttts)<\/li><li>twin anaemia polycythemia syndrome(taps)<\/li><\/ul><p><b>ttts : imbalance of fluid components of the fetal blood.<\/b><\/p><ul><li>donor twin compensates for blood loss by decreasing urine production.<\/li><li>recipient twin compensates for the extra blood by increasing urine production.<\/li><\/ul><p><b>taps : imbalance of the red blood cells.<\/b><\/p><ul><li>donor twin low blood count &#8211; anaemia.<\/li><li>recipient twin thick blood.<\/li><li>amniotic fluid levels remain normal.<\/li><\/ul><h4><span class=\"ez-toc-section\" id=\"mca_pulsatility_index\"><\/span><em><b>mca <\/b><b>pulsatility<\/b><b> index<\/b><\/em><span class=\"ez-toc-section-end\"><\/span><\/h4><ul><li>all fetuses over 34 weeks<\/li><li>abdominal circumference less than 10th centile<\/li><li>estimated fetal weight less than the 10th centile<\/li><li>afi less than 5cm or max vertical pocket less than 2cm<\/li><li>umbilical artery pi greater than 95th centile<\/li><li>mcda twin gestation with ttts<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5b3c5168 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5b3c5168\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2c3b669c\" data-id=\"2c3b669c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7fc57f7a elementor-widget elementor-widget-text-editor\" data-id=\"7fc57f7a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\"><strong>mca scanning technique<\/strong><\/span><\/p><div><ul><li>measure during fetal inactivity.<\/li><li>bpd view of the brain and move slightly caudal<\/li><li>colour flow mapping to locate circle of willis<\/li><li>coronal suture as an acoustic window.<\/li><li>assess the mca closest to the transducer using hd zoom<\/li><li>doppler angle 0 degrees<\/li><li>small doppler gate 0.5-1mm<\/li><li>measure 2mm from mca origin.<\/li><li>optimise doppler baseline and prf to get a large waveform<\/li><li>fewer than 10 consecutive waveforms recorded<\/li><li>report the best measurement out of three taken.<\/li><\/ul><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1aa063c0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1aa063c0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6079cea8\" data-id=\"6079cea8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7a941a10 elementor-widget elementor-widget-text-editor\" data-id=\"7a941a10\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>mca limitations<\/strong><\/p><ul><li>if the fetus&#8217; head cannot be imaged in a decubitus position, then it is impossible to obtain an accurate velocity measurement with an angle greater than 60 degrees. therefore in the later stages of the pregnancy if the head is low and in an occipital anterior or occipital posterior position, the mca cannot be accurately measured.<\/li><li>a transvaginal approach may be required.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-104f1372 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"104f1372\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2e0ad89e\" data-id=\"2e0ad89e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a791e78 elementor-widget elementor-widget-text-editor\" data-id=\"1a791e78\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"normal_%e2%80%93_mca\"><\/span><span style=\"color: #00ccff;\">normal &#8211; mca<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3><h3><span class=\"ez-toc-section\" id=\"normal_pregnancy\"><\/span><b style=\"text-indent: -0.51in; font-size: 16px;\">normal pregnancy<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>high resistance mca<\/li><li><span style=\"text-indent: -0.51in; font-size: 16px;\">low diastolic flow<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2821e585 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2821e585\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-18efb209\" data-id=\"18efb209\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6b94ab66 elementor-grid-2 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"6b94ab66\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-6b94ab66\" href=\"https:\/\/vimeo.com\/453964525\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/950633513-d4af2247db54f2c2969a839cac3fbf63ecd304e412b8e0118afc03a7739a87ce-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tmca colour doppler ultrasound\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tevaluating the mca with colour doppler ultrasound. using the parietal bone as an acoustic window avoids shadowing from the petrous temporal bones or frontal suture.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-6b94ab66\" href=\"https:\/\/vimeo.com\/453587178\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/950005112-06f98cb5aa02026129d82bbb310f7e0521a369be22dc5e8ac21721bfbf488688-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tmca doppler - with sound\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tmiddle cerebral artery doppler 3rd trimester obstetric ultrasound\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6fce2683 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6fce2683\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5eb4498d\" data-id=\"5eb4498d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5536bc88 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"5536bc88\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-18e22ea elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"18e22ea\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bed876c\" data-id=\"bed876c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c5ae7ac elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"c5ae7ac\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-35e5629 elementor-widget elementor-widget-text-editor\" data-id=\"35e5629\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>this image shows the middle cerebral artery at 90 degrees to the beam. the velocity is most accurate the closer the trace done to zero degrees.<\/p><p>the mca has a straight upstroke and is a high resistance waveform with forward flow in systole and diastole.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-60d0b144 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"60d0b144\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-10e1351d\" data-id=\"10e1351d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2c797478 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2c797478\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1c29371f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1c29371f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-792cc4cf\" data-id=\"792cc4cf\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-67dfddec elementor-widget elementor-widget-heading\" data-id=\"67dfddec\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"mca_charts\"><\/span>mca charts<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-19c9bdd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"19c9bdd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5d25731\" data-id=\"5d25731\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-bc61103 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bc61103\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-0982b09\" data-id=\"0982b09\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-544ec9c elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"544ec9c\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/umbilical-artery-pi.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">umbilical artery pulsatility index<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/mca-pi.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">mca pulsatility index<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/cerebro-placental-pi-ratio.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">cerebro-placental ratio pi<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/ductus-venosus-pi.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">ductus venosus<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-9bc99f8\" data-id=\"9bc99f8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7c46536 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"7c46536\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/ua-ri.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">umbilical artery resistive index<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/mca-psv-2.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">mca psv (anemia)<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/uterine-artery-pi.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-clipboard-list\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">uterine artery pi<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-227593e9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"227593e9\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3f25baaf\" data-id=\"3f25baaf\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-56dadc0e elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"56dadc0e\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4a57a8bb elementor-widget elementor-widget-text-editor\" data-id=\"4a57a8bb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>ebbing c, rasmussen s, kiserud t. middle cerebral artery blood flow velocities and pulsatility<br \/>index and the cerebroplacental pulsatility ratio: longitudinal reference ranges and terms for<br \/>serial measurements. ultrasound obstet gynecol, 2007. 30(3): 287-9<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-8713ecc\" data-id=\"8713ecc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6587fe34 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"6587fe34\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f7039e4 elementor-widget elementor-widget-text-editor\" data-id=\"1f7039e4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>if the mca is less than the 5th centile this is significant.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-25db8bb5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"25db8bb5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3900c97e\" data-id=\"3900c97e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1c75e5df elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"1c75e5df\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-42b9d52 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"42b9d52\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4e55449\" data-id=\"4e55449\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-96e2bbc elementor-widget elementor-widget-text-editor\" data-id=\"96e2bbc\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"pathology_%e2%80%93_mca\"><\/span><span style=\"color: #00ccff;\">pathology &#8211; mca<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3><div><p><b>pi less than 5th percentile is abnormal<\/b><\/p><p><b>iugr pregnancy<\/b><\/p><ul><li>placental resistance to blood flow<\/li><li>decreased flow through ua<\/li><li>decreased blood volume redistributes blood to vital organs such as brain, heart , kidneys<\/li><li>mca vasodilation , increased diastolic flow<\/li><li>decreased pi<\/li><\/ul><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0de3978 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0de3978\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6f78967\" data-id=\"6f78967\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ed952b1 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"ed952b1\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5cd927b elementor-widget elementor-widget-text-editor\" data-id=\"5cd927b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>fetal anemia<\/strong><\/p><p>high mca velocities over the course of 45 minutes. ranging between 102 and 120cm\/sec with normal pi.<\/p><p>this baby had come into hospital at 36 weeks 5 days with reduced fetal movements. she had a normal scan the week before. the size of the baby and the ductus venosus and cord dopplers were all normal. no other abnormalities were identified, however the baby did not move for 45 minutes. the obstetrician performed an emergency caesarian and the baby was anemic and required an immediate blood transfusion.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-bb91f41\" data-id=\"bb91f41\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-103aede elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"103aede\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-db7876e elementor-widget elementor-widget-text-editor\" data-id=\"db7876e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>there is reversal of flow in the mca which increases the risk of cerebral haemorrhage and fetal death in utero in cases where it is sustained. there is a high pi also.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7adc8bb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7adc8bb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-133d923\" data-id=\"133d923\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2ab69a9 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2ab69a9\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e65c7c5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e65c7c5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0fb6799\" data-id=\"0fb6799\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-fd23b82 elementor-widget elementor-widget-heading\" data-id=\"fd23b82\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"ductus_venosus_dv\"><\/span>ductus venosus (dv)<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-67a46ab3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"67a46ab3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-704e464d\" data-id=\"704e464d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-65c54e22 elementor-widget elementor-widget-text-editor\" data-id=\"65c54e22\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>role of ultrasound \/ indications<\/strong><\/em><\/p><ul><li>the dv plays a critical role in delivering blood rich with oxygen and nutrients from the placenta to the fetal heart.\u00a0<\/li><li>the dv is a branchless, hourglass\u2010shaped vessel narrowing to 1\u20132 mm, approximately one third of the width of the uv so 25% of blood is shunted to the ivc under pressure , propels blood into the ra and directly into the la.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-32e63e67 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"32e63e67\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-16391630\" data-id=\"16391630\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-fa6ed38 elementor-widget elementor-widget-text-editor\" data-id=\"fa6ed38\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: left;\"><em><strong>scanning technique<\/strong><\/em><\/p><p style=\"text-align: left;\"><span style=\"text-decoration: underline;\">in early morphology scanning<\/span><\/p><div><ul><li>a right mid-sagittal view of the fetal trunk , colour flow mapping used to demonstrate the uv, dv and heart.<\/li><li>sampled at the inlet to dv<\/li><li>small sample volume 0.5-1mm<\/li><li>doppler angle less than 30 degrees<\/li><\/ul><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-12b89757 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"12b89757\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-201460f0\" data-id=\"201460f0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-645280eb elementor-widget elementor-widget-text-editor\" data-id=\"645280eb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>limitations<\/strong><\/em><\/p><ul><li>if the ductus venosus is parallel to the ultrasound beam it is impossible to gain an accurate spectral doppler trace.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1226a2e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1226a2e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fec46c8\" data-id=\"fec46c8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6f7c6b0 elementor-widget elementor-widget-text-editor\" data-id=\"6f7c6b0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"normal_%e2%80%93_ductus_venosus_1st_and_3rd_trimester\"><\/span><span style=\"color: #00ccff;\">normal &#8211; ductus venosus 1st and 3rd trimester<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-26c9bf9d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"26c9bf9d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-299fd532\" data-id=\"299fd532\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3e4a1ac2 elementor-grid-2 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"3e4a1ac2\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-3e4a1ac2\" href=\"https:\/\/vimeo.com\/453590599\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/950010175-5e81c0dcf517c7513f06458dcea6abaf434a3a7a5b01d5c2113d6c3fc8f384c5-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tductus venosus doppler - 1st trimester\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\ta parasagittal plane. the normal dv flow is displayed below the baseline in this example. higher resistance (end diastolic flow approaching the baseline).\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-3e4a1ac2\" href=\"https:\/\/vimeo.com\/453589428\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/950008768-7c1bcaad895e627d146689d9b882001e69a98162d1e86933e4878e73dfc28ef0-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tductus venosus doppler - 3rd trimester\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\t3rd trimester axial plane.\nthe normal lower resistance waveform of ductus venosus in the 3rd trimester.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a83bbb4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a83bbb4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-156b55c\" data-id=\"156b55c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-884b7e6 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"884b7e6\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3f0a4d4 elementor-widget elementor-widget-text-editor\" data-id=\"3f0a4d4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>because of turbulent flow, the dv often has a &#8220;sparkling&#8221; appearance which is the result of aliasing.<\/li><li>should have continuous forward flow towards the heart<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-081f677\" data-id=\"081f677\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0235966 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"0235966\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5e82eea elementor-widget elementor-widget-text-editor\" data-id=\"5e82eea\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>the dv waveform relates to atrial pressure and volume changes throughout the entire cardiac cycle, producing a multiphasic flow pattern<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-72194385 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"72194385\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-495355c9\" data-id=\"495355c9\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-47535a5 elementor-widget elementor-widget-text-editor\" data-id=\"47535a5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"pathology_%e2%80%93_ductus_venosus\"><\/span><span style=\"color: #00ccff;\">pathology &#8211; ductus venosus<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c3e3189 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c3e3189\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-d988f78\" data-id=\"d988f78\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9238ee6 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"9238ee6\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fef3236 elementor-widget elementor-widget-text-editor\" data-id=\"fef3236\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>there is obvious reversal of the a-wave in this 22 week pregnancy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-ed3e970\" data-id=\"ed3e970\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-649c96a8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"649c96a8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-64e06b35\" data-id=\"64e06b35\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4f474901 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"4f474901\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e70c36e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e70c36e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7832bbe\" data-id=\"7832bbe\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7135b9d elementor-widget elementor-widget-heading\" data-id=\"7135b9d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"uterine_arteries\"><\/span>uterine arteries<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-637f8668 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"637f8668\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6568b832\" data-id=\"6568b832\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9ba21c2 elementor-widget elementor-widget-text-editor\" data-id=\"9ba21c2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>role of ultrasound \/ indications<\/strong><\/em><\/p><p>provides important information on the conversion process of spiral arteries into uteroplacental arteries<\/p><p>provides flow resistance information on the maternal surface of the placenta<\/p><p>preeclampsia screening in the first and second trimester<\/p><p>fetal growth restriction (iugr) in early pregnancy<\/p><p>patients with pregnancy induced hypertension<\/p><p>early sga fetuses at 20 weeks<\/p><p>preeclampsia is a major cause of maternal and perinatal morbidity and mortality , affecting 2-3 % of all pregnancies.<br \/>in a normal pregnancy<\/p><p>placental cells invade the inner third of the myometrium &#8211;<\/p><p>the entire length of the maternal spiral arteries dilate to optimise delivery of oxygen and nutrients to the fetus.<\/p><p>in women with preeclampsia<\/p><p>there is a failure of trophoblast invasion<\/p><p>the spiral arteries maintain muscle elastic coating so impedance to blood flow persists.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-594bbfe8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"594bbfe8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4b7b356e\" data-id=\"4b7b356e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-105de619 elementor-widget elementor-widget-text-editor\" data-id=\"105de619\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>limitations<\/strong><\/em><\/p><ul><li>there should not be any limitations to scanning however a half full bladder improves the visualisation of the uterine arteries.\u00a0<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7cad8c96 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7cad8c96\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-12973ed9\" data-id=\"12973ed9\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-44b94803 elementor-widget elementor-widget-text-editor\" data-id=\"44b94803\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>patient preparation<\/strong><\/em><\/p><ul><li>at least 200mls in the bladder will improve visualisation in the first trimester.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4b405718 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4b405718\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d3b41ca\" data-id=\"d3b41ca\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1c2fb5b7 elementor-widget elementor-widget-text-editor\" data-id=\"1c2fb5b7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>scanning technique<\/strong><\/em><\/p><p><strong><u>trans abdominal scanning in first trimester<\/u><\/strong><\/p><ul><li>mid sagittal on the uterus and cervix (half full bladder)<\/li><li>keep probe in the midline and angle slightly lateral until paracervical vascular plexus is seen.<\/li><li>measure ua as it turns cranially to make its ascent to the uterine body.<\/li><li>psv greater than 60cm\/s (to make sure not measuring the arcuate arteries)<\/li><li>doppler angle less than 30 degrees , (it is easy to get it in complete alignment with blood flow)<\/li><li>doppler gate 2mm wall filter 30-60 hz<\/li><li>show 3 consecutive waveforms to measure pi.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-308d469a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"308d469a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-67edfed\" data-id=\"67edfed\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7f0372a8 elementor-grid-1 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"7f0372a8\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-7f0372a8\" href=\"https:\/\/vimeo.com\/444767990\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/935230941-3bebe6d871b751f6f5d220b2e875740c2af6939c3b8522c303f7210796f0421b-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound uterine artery doppler at 12 weeks gestation\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\twith sound. approach is lateral to the cervix.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-359733ea elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"359733ea\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2c040994\" data-id=\"2c040994\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-321dff99 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"321dff99\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2fc9ecb4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2fc9ecb4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-56d9316b\" data-id=\"56d9316b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3c5681da elementor-widget elementor-widget-text-editor\" data-id=\"3c5681da\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\"><strong>trans abdominal scanning &#8211; 2nd\/3rd trimester<\/strong><\/span><\/p><ul><li>probe is placed longitudinally in the lower lateral quadrant of the abdomen and angled medially.<\/li><li>colour flow mapping is used to identify the uterine artery as it is seen crossing the external iliac artery.<\/li><li>sample volume placed 1cm downstream from this crossover point.<\/li><li>if the uterine artery bifurcates , measure before this.<\/li><li>with advancing maternal age, the uterus rotates clockwise so left side not as lateral as the right side.<\/li><li>doppler angle less than 30 degrees<\/li><li>doppler gate 2mm wall filter 30-60 hz<\/li><li>show 3 consecutive waveforms to measure pi.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bd06de5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bd06de5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-27edab3\" data-id=\"27edab3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-49b1ad62 elementor-grid-1 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"49b1ad62\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-49b1ad62\" href=\"https:\/\/vimeo.com\/444770686\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/935235736-6a69d73522de2c4e4b07aa443a968b8e8e9a8fc4c4c50841f03e7f79a148b550-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tuterine artery doppler at 19weeks with sound\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tthe uterine artery sampled adjacent to the external iliac artery. normal low resistance flow.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-63e8443c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"63e8443c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5e688f95\" data-id=\"5e688f95\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7e5662d0 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"7e5662d0\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-fa13983 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fa13983\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6db6a9c6\" data-id=\"6db6a9c6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-33224300 elementor-widget elementor-widget-text-editor\" data-id=\"33224300\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"uterine_artery_%e2%80%93_normal\"><\/span><span style=\"color: #00ccff;\">uterine artery &#8211; normal<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-34b7083 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"34b7083\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-f0f72d4\" data-id=\"f0f72d4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c56f080 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"c56f080\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d89215d elementor-widget elementor-widget-text-editor\" data-id=\"d89215d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>in the non-pregnant state there is rapid rise and fall in uterine artery flow velocity during systole.<\/p><p>there is a notch in the descending waveform in early diastole.<\/p><p>\u00a0<\/p><p>\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-57f6f09\" data-id=\"57f6f09\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-31830f7 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"31830f7\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1d8814f elementor-widget elementor-widget-text-editor\" data-id=\"1d8814f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>at 12 weeks (diastolic notch up to 16 weeks)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-48e06725 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"48e06725\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-41e8d56d\" data-id=\"41e8d56d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2072afc5 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"2072afc5\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3bfbf161 elementor-widget elementor-widget-text-editor\" data-id=\"3bfbf161\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>normal uterine artery flows at 19 weeks gestation<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-436da30f\" data-id=\"436da30f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6ab32238 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"6ab32238\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-67abddb9 elementor-widget elementor-widget-text-editor\" data-id=\"67abddb9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>normal uterine artery waveforms in 3rd trimester. note the rising diastolic flow<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1877cd8c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1877cd8c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-80b707a\" data-id=\"80b707a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5b277b41 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"5b277b41\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3fa20b0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3fa20b0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b82ac86\" data-id=\"b82ac86\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d1a070b elementor-widget elementor-widget-text-editor\" data-id=\"d1a070b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"uterine_artery_%e2%80%93_pathology\"><\/span><span style=\"color: #00ccff;\">uterine artery &#8211; pathology<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5717cd0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5717cd0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-e201950\" data-id=\"e201950\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9a948c5 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"9a948c5\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0fe286e elementor-widget elementor-widget-text-editor\" data-id=\"0fe286e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>preeclampsia- there is a notch which persists and low diastolic flow, showing increased impedance.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-47507fa\" data-id=\"47507fa\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4bde4e0 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"4bde4e0\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aca62f4 elementor-widget elementor-widget-text-editor\" data-id=\"aca62f4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>preeclampsia &#8211; note the reversed flow in early diastole due to the very high resistance to flow.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>we would like to acknowledge ms. sarah dowthwaite for providing invaluable\u00a0 information for this section. oxygenated, nutrient rich blood placental blood enters the foetus via the umbilical vein. the umbilical vein joins the portal venous system in the liver, some umbilical blood is shunted directly to the ivc and right heart via ductus venosus. blood [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"tags":[],"class_list":["post-10402","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/10402","targethints":{"allow":["get"]}}],"collection":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/comments?post=10402"}],"version-history":[{"count":0,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/10402\/revisions"}],"wp:attachment":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/media?parent=10402"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/tags?post=10402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}