1 Hte4 - minsante-cdnss.cm

Préliminaires
AB8TRACT
Introduction
High risk pregnancies are characterised by the fact that the vital foetal
and / or maternai outcomes are imperilled. They therefore need adequate
care.
Furthermore, the growth and weIl being of the fœtus depends on the
quality of the placental perfusion. Under normal physiological conditions,
vascular resistance decreases gradually while foeto-placenta! blood flow
increases throughout the gestation period with a value of about 110 ta
120mljminjkg. In sorne pathological cases [preeclampsia, intra-uterine
growth retardation (IUGR), hydramnios, pregnant subject with insulin
required diabetus mellitus], there is an increase in placenta! vascular
resistance which has an effect at the level of the umbilical artery, the last
blood vesse! before the placenta! obstacle, by a decreased of diastolic blood
flow velocity.
The Doppler velocimetry consists of measuring the systolic and
diastolic blood flow velocity using ultrasound. This technique is used in an
atraumatic manner to assess the maternaI vessels (uterine artery), placenta!
vessel (umbilical artery), foetal vessels (aorta, cerebral artery, ~enal artery,
femoral artery, mesenteric artery). It is generally used for diagnosis,
treatment and prognosis assessment.
At the level of umbilical artery, the Doppler velocimetric study is a
good reflection of the feoto-placental perfusion.
In this regard, indexes (blood velocity ratio) were defined to facilitate
the study. These indexes include : the STUART and DRUMM index, the
MILLIEZ and PERONNEAU index, the POURCELOT index and the pulsatility
index.
In Cameroon, there has been no study on fœtal prognosis in high risk
pregnancies. 8ince there is a high frequency of preeclampsia, intrauterine
growth retardation and hydramnios in our society, we though it will he
SAGNE - Doppler ombilical et pronostic fœtal des grossesses et hBut risque - Thése Doc. M~d. - FMSB
xx