[Chorionic villi sampling. Amniocentesis. Cordocentesis]. / Prélèvement de villosités choriales. Amniocentèse. Cordocentèse.

For early antenatal diagnosis, chorionic villus sampling (CVS) represents a valid alternative to early amniocentesis. It gives rapid results with minimal increase in risks (miscarriage about 1.5 p. cent). The indications of CVS are therefore likely to broaden. For late antenatal diagnosis, linked to an echographic or clinical anomaly, sampling of fetal blood by funicular puncture is taking precedence over sampling of amniotic fluid. Results can be obtained easily and much more quickly at low risk (about 1 p. cent). These techniques are in no way alternatives, but rather complement one another. It is always advisable to choose with care the technique that offers the greatest information with maximum safety.

[The contribution of umbilical Doppler velocimetry in suspected echographic IUGR]. / Apport de la vélocimétrie Doppler ombilicale dans les suspicions échographiques de R.C.I.U.

Doppler pulses or continuous flow in the umbilical artery is a technique recently used in practical obstetrics and of value particularly in screening at risk pregnancies. The authors wish to study its value as a diagnostic and prognostic tool in the special cases where ultrasound has given rise to a suggestion that there may be intra-uterine growth retardation (I.U.G.R.). In a preliminary publication they report their experience in 100 normal pregnancies so that they have obtained a control diagram. Then, working on a population of 117 pregnancies with ultrasonically diagnosed I.U.G.R. they studied the birth-weight, the early neonatal morbidity and the neonatal mortality as a function of the Pourcelot S - D/S index. They were able to separate out 63 cases of I.U.G.R. without any hypertension and 54 cases associated with hypertension. They analyse the same parameters. They then discuss first the value of the diagram they have made in comparison with other known curves, also the diagnostic and prognostic performance of the method. They conclude that there is a moderate diagnostic value in Doppler velocimetry. The prognostic value is much better because the Doppler can differentiate those case of slow growth that are going to do well against those that are going to do badly.