Introduction: Uterine artery (UA) Doppler assessment provides insight into uteroplacental perfusion throughout pregnancy and plays a key role in the early identification of placental dysfunction and pre-eclampsia. Abnormal UA resistance reflects impaired trophoblastic invasion and abnormal placentation. This presentation aims to review the use of UA Doppler throughout pregnancy, with particular focus on first- and second-trimester, optimisation of sonographic technique, and the role of ultrasound in pre-eclampsia risk stratification.
Methods: A focused review of peer-reviewed literature was undertaken examining UA Doppler indices from the first through second trimester and their clinical significance. Sonographic techniques for accurate UA identification and waveform acquisition are discussed, including probe positioning, colour Doppler settings, angle correction, sampling site, and optimisation of Doppler traces. The integration of UA Doppler into combined screening models and ongoing surveillance pathways is also explored.
Results: First-trimester UA Doppler, particularly elevated pulsatility index (PI), is strongly associated with increased risk of early-onset pre-eclampsia and fetal growth restriction. Second-trimester assessment provides additional prognostic value, assisting in the identification of pregnancies at risk of late-onset disease and guiding ongoing surveillance. Consistent evidence demonstrates that accurate and standardised Doppler technique improves reproducibility and predictive performance.
Conclusion: UA Doppler assessment across pregnancy is a valuable, non-invasive ultrasound tool that supports early detection and ongoing evaluation of placental disease when performed using optimal sonographic technique.
Take-home message: High-quality UA Doppler assessment in both the first and second trimester enhances pre-eclampsia risk stratification and highlights the critical role of sonographers in preventative obstetric care.

Sonographers typically screen fetal growth to detect when babies may be measuring smaller than expected, with less focus on the significance of babies measuring large for gestational age (LGA). While underappreciated, LGA babies can be at increased risk of adverse perinatal outcomes.
This talk will discuss the triggers for suspicion of LGA and what we should be paying attention to when performing these scans. The use and limitations of fetal growth charts will be discussed as well as what current research shows regarding the outcomes of LGA babies.
LGA babies may be at risk for perinatal complications despite the assumption that this is reserved for babies that are growth restricted. However, growth charts remain an ongoing clinical challenge when screening fetal growth due to lack of consensus.
Take home message: Understanding the importance of screening and management of LGA pregnancies is essential for all clinicians involved in their care.

Fetal growth restriction (FGR) contributes significantly to perinatal morbidity and mortality, and Doppler ultrasound is vital in its assessment. Doppler assessment provides an understanding of placental function and fetal haemodynamic adaptation, which helps to support clinical decision making.
This presentation will examine the physiological basis and interpretation of the Doppler indices used in FGR; the umbilical artery, middle cerebral artery, cerebroplacental ratio, and ductus venosus. Umbilical artery Doppler will be discussed as an indicator of placental resistance, particularly in early onset FGR. The middle cerebral artery pulsatility index and the cerebroplacental ratio will be discussed as markers of redistribution in the fetal circulation, and the ductus venosus will be presented as an indicator of imminent fetal decompensation and impaired cardiac function.
By demonstrating the haemodynamic significance of each Doppler parameter, this lecture aims to enhance sonographer’s understanding of Doppler findings and their relevance within the clinical scenario of FGR.

Aim: To determine the accuracy of sonographically estimated foetal birthweight (SEFW) in a Guyanese population and identify its influencing factors.
Method: Data involving pregnant women who had an obstetric ultrasound (U/S), at maximum, 3 days prior to birth were retrospectively collected from January 01, 2016 to December 31,2017. Exclusion criteria included twin pregnancies, congenital abnormalities, and stillbirths. Maternal, fetal, gestational, and sonographic data were gathered. Actual fetal birthweights (ABWs) were compared to SEFWs and accuracy metrics such as systematic error (SE), random error (RE), mean absolute percent error (MAPE), and accuracy proportion (MAPE ≤ 10%) were calculated. Spearman's correlation and χ2 tests identified factors influencing SEFW accuracy.
Results: A total of 531 U/Ss were performed, at maximum, 3 days prior to birth. The mean SEFW and ABW were 3155.5 grams (±642.95 grams) and 3079.5 grams (±638.70 grams), with a mean U/S to birth interval of 1.4 days (±0.9 days). The SE, RE and MAPE were 3.51%, 14.21%, and 11.06%, respectively. 56.31% (n = 299) of the SEFW were accurate (95% CI 51.97% - 60.58%). The area under the receiver operating characteristic curve for the accuracy of SEFW was 0.5206 (95% CI 0.4708 – 0.5705). Maternal hypertension, pre-eclampsia/eclampsia, U/S examiner, foetal sex and foetal birthweight were the variables influencing SEFW accuracy.
Conclusion: In the Guyanese population, SEFW demonstrates poor accuracy; obstetricians should be cautious of relying on SEFW to manage obstetric patients. Implementing quality control measures could enhance SEFW accuracy.