Self-selected expectant management of post dates pregnancy including the use of Doppler ultrasound

Summary

The need for intervention in prolonged but otherwise normal pregnancy is frequently questioned. The conservative management of post dates pregnancy, and the possible contribution of Doppler blood How studies to this were assessed in an observational study of 167 women with apparently normal post dates pregnancies. There was no difference in mean Doppler indices between 16 women delivered for fetal distress and other women. Fetal distress was more common after 290 days and following induction. Antenatal cardiotocography and Doppler studies failed to predict one stillbirth. These findings agree with other studies casting doubt on the value of Doppler in the management of the post dates pregnancy, possibly because the deterioration in placental function occurs with no reduction in blood flow.