[The contribution of umbilical and cerebral Doppler velocimetry in the diagnosis and monitoring of intrauterine growth retardation].

The authors studied the arterial circulation in the umbilicus and brain in 140 cases of intrauterine delayed growth using a pulsed Döppler system. Results were expressed in terms of a circulatory index. The Pourcelot resistance index is defined as S-D/S, where S represents the maximum systolic rate and D the maximum telediastolic rate and is used both for the umbilicus (Rp) and the brain (Rc). In order to evaluate the diagnostic and prognostic performance of the Döppler method, the values of the various indices were analyzed as a function of the foetal cardiac rhythm during labour, the method of delivery and the state of the infant at birth. The authors concluded that umbilical blood flow measurement was of moderate diagnostic values, while the unitary placental resistance index was of undeniable prognostic value (76 p. cent of foetal distress at birth, perinatal mortality of 30.30 p. cent). A pathological brain resistance index preceded the occurrence of abnormalities in foetal cardiac rhythm by 24 hours to 5 days in 64.28 p. cent of the cases and was always associated with foetal distress at birth. The authors considered it was important to take the respective short-term changes in values of the various circulatory indices into consideration rather than the isolated values themselves. The brain-placenta ratio (BPR = Rc/Rp) may perhaps constitute the best indication in the early screening of foetal hypoxia.