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L’échographie obstétricale chez la femme obèse

Obstetric ultrasound in obese women

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Revue de médecine périnatale

Résumé

La prévalence de l’obésité augmente régulièrement, particulièrement dans la population féminine en âge de procréer. Les foetus issus de grossesses de mères obèses voient leur risque malformatif plus élevé que dans la population générale. La performance de l’échographie dans le dépistage est fortement réduite par l’obésité et proportionnellement à sa sévérité. Les moyens d’amélioration des performances de l’échographie dans cette situation sont, principalement, un balayage ultrasonore favorisant les fenêtres acoustiques où l’épaisseur du pannicule est la moins importante et une optimisation des réglages d’image parmi lesquels le paramètre « vitesse de propagation des ultrasons » doit être pris en compte. L’échographiste doit, par ailleurs, veiller à optimiser son ergonomie de travail afin de prévenir les troubles musculosquelettiques et veiller à informer les patientes des limites de l’examen afin de prévenir le risque médicolégal.

Abstract

The prevalence of obesity increases steadily, mainly among the female population of childbearing age. Fetuses from pregnancies of obese mothers have a higher risk of malformation than in the general population. The performance of screening ultrasound is strongly reduced by obesity and proportional to its severity. The tricks for improving the performance of ultrasound in this situation are mainly an ultrasonic scan favoring acoustic windows where the thickness of the pannicle is the least important and an optimization of the image adjustments among which the parameter “speed of propagation of ultrasound” should be taken into account. The sonographer must also optimize his ergonomics to prevent musculoskeletal disorders and ensure that patients are informed of the limits of the examination in order to prevent medico-legal risk.

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Authors and Affiliations

  1. CHU Estaing, 1 place Lucie et Raymond Aubrac, F-63003, Clermont-Ferrand cedex 1, France

    D. Lemery

  2. EA 4681 Peprade, université d’Auvergne, Clermont-Ferrand, France

    D. Lemery, B. Chauveau & A. Legrand

  3. Pôle d’imagerie, CHU Gabriel Montpied, rue Montalembert, F-63003, Clermont-Ferrand cedex 1, France

    B. Chauveau & L. Boyer

  4. Réseau de santé en périnatalité d’Auvergne, pôle Femme et Enfant, CHU Estaing, 1 place Lucie et Raymond Aubrac, F-63003, Clermont-Ferrand cedex 1, France

    A. Legrand

Authors
  1. D. Lemery
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  2. B. Chauveau
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  3. A. Legrand
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  4. L. Boyer
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Correspondence to D. Lemery.

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Lemery, D., Chauveau, B., Legrand, A. et al. L’échographie obstétricale chez la femme obèse. Rev. med. perinat. 8, 180–186 (2016). https://doi.org/10.1007/s12611-016-0389-1

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  • DOI: https://doi.org/10.1007/s12611-016-0389-1

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