{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:08:15Z","timestamp":1784268495981,"version":"3.55.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Early applications of fetal Doppler evaluation drew on parameters derived from adult vascular examination, primarily applied to identifying fetuses at risk for growth restriction and hypoxia. The integration of color Doppler into real-time imaging facilitated a shift toward structural-functional correlation, enabling clinicians to visualize fetal cardiac outflow tracts, valve regurgitant jets, and the complex umbilical\u2013venous connections alongside standard grayscale anatomy. Power Doppler extended these capabilities to slow flow and small caliber vascular structures. Doppler modalities have been crucial in delineating the fetal cardiovascular system, increasingly detecting complex congenital heart disease (CHD) prenatally, and illuminating cardiac and non-cardiac vascular structures that previously posed a challenge to visualization, including cerebral, hepatic, and placental capillary beds. Highly sensitive Doppler technologies such as Slow\n                    <jats:italic>flow<\/jats:italic>\n                    HD as well as MV-Flow and LumiFlow, exemplify the convergence of anatomical and physiological imaging, such as fetal venous sinuses and deep cerebral venous return, to allow brain perfusion assessment at earlier gestational stages. Although Slow\n                    <jats:italic>flow<\/jats:italic>\n                    HD has been shown to have added value for diagnosis, it seems to be an underused modality. Here we show several examples drawn from our experience with Slow\n                    <jats:italic>flow<\/jats:italic>\n                    HD, in both routine scanning and anomalous cases spanning various organ systems and stages of gestation. While there is a learning curve in optimizing image acquisition and interpretation of microvascular anatomy, it should not deter practitioners proficient in Doppler techniques. We recommend incorporation of Slow\n                    <jats:italic>flow<\/jats:italic>\n                    HD and comparable microvascular imaging technologies into the sonographic armamentarium.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1878231","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:44:20Z","timestamp":1784267060000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolution of Doppler ultrasound in obstetric imaging: a slow(flow) step forward"],"prefix":"10.3389","volume":"13","author":[{"given":"Simcha","family":"Yagel","sequence":"first","affiliation":[{"name":"Division of Obstetrics and Gynecology, Hadassah University Medical Center","place":["Jerusalem, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynecology, Hadassah University Medical Center","place":["Jerusalem, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Shwartz","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynecology, Hadassah University Medical Center","place":["Jerusalem, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan V.","family":"Valsky","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynecology, Hadassah University Medical Center","place":["Jerusalem, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1136\/bmj.2.6100.1450","article-title":"Non-invasive measurement of human fetal circulation using ultrasound: a new method","volume":"2","author":"FitzGerald","year":"1977","journal-title":"Br Med J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1515\/jpme.1990.18.3.165","article-title":"Normal values of pulsatility index from fetal vessels: a cross-sectional study on 1556 healthy fetuses","volume":"18","author":"Arduini","year":"1990","journal-title":"J Perinat Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/s0002-9378(85)80016-8","article-title":"Flow velocity waveforms in the maternal uteroplacental and fetal umbilical placental circulations","volume":"152","author":"Trudinger","year":"1985","journal-title":"Am J Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/0301-5629(79)90014-0","article-title":"Investigation of the uteroplacental circulation by Doppler ultrasound","volume":"11","author":"Campbell","year":"1987","journal-title":"Semin Perinatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/0301-5629(79)90014-0","article-title":"Pulsed Doppler with B-mode imaging for quantitative blood flow measurement","volume":"5","author":"Gill","year":"1979","journal-title":"Ultrasound Med Biol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/s0140-6736(83)91970-0","article-title":"New doppler technique for assessing uteroplacental blood flow","volume":"321","author":"Campbell","year":"1983","journal-title":"Lancet"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1016\/S0889-8545(21)00255-2","article-title":"Doppler echocardiography and color flow mapping","volume":"18","author":"Copel","year":"1991","journal-title":"Obstet Gynecol Clin N Am"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1515\/jpme.1991.19.1-2.27","article-title":"Color Doppler flow mapping of fetal heart","volume":"19","author":"Gembruch","year":"1991","journal-title":"J Perinat Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/0002-9378(87)90110-4","article-title":"Fetal echocardiography. 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