الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
High-risk pregnancy is a term applied to those pregnancies, which are complicated, or at increased risk of developing complications which affect fetal-wellbeing during the course of pregnancy. Doppler assessment of vascular changes of placental and fetal circulation associated with such complications are of value. Conventional ultrasound aids in assessment as a part of modified BPP. PURPOSE: . This work aimed to evaluation of the role of ultrasound and Doppler examinations in the assessment of some high-risk pregnancies. MATERIALS AND METHODS: The study was carried out on 97 singleton pregnancies; 34 low-risk & 63 high-risk cases (19 pre-eclampsia, 13 DM, 7 chronic, 9 Rh. ht. , 5 LCF, 4 Rh isoimmunization, 4 anemia and 2 SLE. All cases were subjected to conventional and Doppler ultrasound examinations. Doppler examination of the umbilical artery and fetal middle cerebral arteries (PI, RI and S/D ratio) were obtained. C/U ratio was calculated. Additional assessment using the modified BBP was performed in 15 cases of the high-risk pregnancy group. RESULTS: Abnormal umbilical artery Doppler findings were found in 7 cases of the low-risk group (20.6 %) and in 18 cases of the high-risk group (25.4 %). Two cases, among the high-risk group had absent end-diastolic flow velocity (AEDV); both cases were complicated by perinatal mortality. Umbilical artery Doppler examination showed sensitivity and specificity 71.4 % & 92.6 % respectively, versus 58.3 % & 94.9 % in the high-risk group. The middle cerebral artery showed abnormal results in 9 low-risk cases and 29 high-risk cases with sensitivity and specificity of 100 %, 80.6 % versus 90.3 % & 74.4 % in the high-risk cases. Thirty-two cases showed brain sparing effect. The C/U ratio was abnormal in 9 high-risk cases and only one case in 2 he low-risk cases. In our study the main perinatal complications occurred with hypertensive disorders of pregnancy. Doppler examination revealed sensitivity and specificity equal to 57.5 % and 60.9 % for the prediction of adverse fetal outcome in the high-risk pregnancies. In the low-risk pregnancies Doppler sensitivity and specificity were 75 % and 80.8 % respectively. The modified BPP showed lower sensitivity and higher specificity comparing to the Doppler examination. CONCLUSION: Doppler derived vascular pattern helps in the prediction and hence management of adverse perinatal complications in the high-risk cases and as a screening tool in low-risk cases. Doppler examination add to the management of small-for-date fetuses. AREDV of UA are associated with high incidence of perinatal fetal morbidity and mortality. The value of conventional US should not be ignored in the assessing fetal well-being; fetal growth rate.