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Préliminaires
indexes were abnormal (5 cases of pre,eclampsia, 4 cases of IUGR, 2 cases of
hydramnios and one case of preeclampsia combined with IUGR).
The perinatal morbidity rate was 'generally 36.53 % (19 cases of poor
perinatal status out of 52 new-born babies). The global perinatal mortality
rate was 15.38 % (8 deaths out of 52). Out of the recorded deaths, 7 cases
had a pathological Doppler (equivalent to a mortality rate of 58.33 % within
this group.
In two cases, umbili(~al Doppler was highly pathological (one case of
absent end diastolic blood flow). In both cases, death resulted in the womb.
We noticed that the 11mbilical pulsatility index was negligible in fœtal
prognosis when it was pathological (p = 0.6179). The specificity of that index
was 9.07 0/0, its sensitivity was 94.7 % and its positive predictive value was
75 %. Therefore, the prognosis value of that index is low when it is
pathologie and satisfactory ·when the index is normal.
Furthermore, the unlbilical POURCELOT index was very significant
according to the fœtal pro~~nosis (p = 0.000006). Its sensitivity was 57.9 °ib
and its specificity 97 °ib. It:s positive predictive value was 91.7 °ib while tqe
negative predictive value ~7as 80 0/0. The prognostic value of the index is
therefore very high when it is normal or pathological.
Conclusion
The study shows that the fœtal prognosis is good when the two
indexes are normal and unfavourable when the two indexes are pathological.
The prognosis is highly unfavourable in cases of absent or reverse end
diastolic blood flow, which would therefore require emergency fœtal
extraction.
SAGNE - Doppler omblical et pronostic fœtal c'es grossesses à haut risque - Thése Doc. M~d. - FM5B
XXII