Läkartidningen
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Doppler ultrasound is a well established technique for evaluating impedance to blood flow. A review of current literature in the field yields convincing support for the use of obstetric Doppler ultrasonography in the management of high-risk pregnancies. ⋯ However, every technique has its limitations, and it should be borne in mind that even if fetal hypoxia is often revealed by an abnormal Doppler ultrasound result before the cardiotocography pattern becomes abnormal, it is nonetheless a late sign. It is concluded in the article that Doppler ultrasonography needs to be combined with other methods, such as the measurement of biochemical markers, to ensure satisfactory fetal monitoring.
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The need both of critical assessment of community intervention programmes and of alternatives to randomised controlled studies is discussed in the article. Examples are drawn from a review recently completed for the Swedish Council on Technology Assessment in Health Care [Statens Beredning för Utvärdering av medicinsk metodik (SBU)], and from the evaluation of a cardiovascular disease prevention programme currently in progress in northern Sweden.