Abstract
Objectives
To evaluate the cerebroplacental ratio which is the ratio of pulsatility index of fetal middle cerebral and umbilical arteries, in normal and high-risk pregnancies during 30–36 weeks of gestation.
Methods
In this study, we included 70 patients, who were scanned for Doppler parameters of Middle cerebral artery and Umbilical artery pulsatility index ratio of fetus, between 30 and 36 weeks, and then were followed till delivery. Thirty-five patients with normal pregnancy and 35 patients with high-risk pregnancy were included. Perinatal outcome was evaluated in relation to indices ratio.
Results
There was cerebroplacental ratio of <1.00 in eight cases of the study group in comparison with the control group in which there is no case of <1.00 value. It was associated with poor perinatal outcome in terms of need for lower segment cesarean section for fetal distress, Apgar <8 at 5 min, and admission to nursery.
Conclusion
Cerebroplacental ratio is highly sensitive in diagnosing hemodynamically compromised fetuses and very useful for the prediction of adverse perinatal outcome in these fetuses.
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References
Malik R, Saxena A. Role of colour Doppler indices in the diagnosis of intrauterine growth retardation in high risk pregnancies. J Obstet Gynecol India. 2013;63(1):37. doi:10.1007/s13224-012-0210-4.
Khanduri S, Parashari UC, Bashir S, et al. Comparison of diagnostic efficacy of umbilical artery and middle cerebral artery waveform with color Doppler study for detection of intrauterine growth restriction. J Obstet Gynecol India. 2013;63(4):249.
Morrissette MM. Abnormal fetal umbilical cord doppler? What should i Do next? A case study demonstrating corroboration of umbilical cord doppler and middle cerebral doppler. J Diagn Med Sonogr. 2012;28(4):179–82. doi:10.1177/8756479312441503.
Benavides-Serralde A, Scheier M, Cruz-Martinez R, et al. Changes in central and peripheral circulation in intrauterine growth-restricted fetuses at different stages of umbilical artery flow deterioration: new fetal cardiac and brain parameters. Gynecol Obster Investig. 2011;71(4):274–80. doi:10.1159/000323548.
Hernandez-Andrade E, Stampalija T, Figueras F. Cerebral blood flow studies in the diagnosis and management of intrauterine growth restriction. Curr Opin Obstet Gynecol. 2013;25(2):138–44. doi:10.1097/GCO.0b013e32835e0e9.
Zhu MY, Milligan N, Keating S, et al. The hemodynamics of late-onset intrauterine growth restriction by MRI. Am J Obstet Gynecol. 2016;214(3):367.e1–17. doi:10.1016/j.ajog.2015.10.004.
Mureşan D, Rotar IC, Stamatian F. The usefulness of fetal Doppler evaluation in early versus late onset intrauterine growth restriction. Review of the literature. Med Ultrason. 2016;18(1):103–9. doi:10.11152/mu.2013.2066.181.dop.
DeVore GR. The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses. Am J Obstet Gynecol. 2015;213(1):5–15. doi:10.1016/j.ajog.2015.05.024.
Maged AM, Abdelhafez A, Mostafa WAI et al. Fetal middle cerebral and umbilical artery Doppler after 40 weeks gestational age. J Matern Fetal Neonatal Med. 2014;27(18):1880–5. doi:10.3109/14767058.2014.892068.
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The authors have no conflict of interest.
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The research is in compliance with ethical standard. Permission has been taken and is approved by institutional ethical committee.
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Informed consent was obtained from all patients for being included in the study.
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Dr. Anita Kant MBBS, MS, FICOG, is Director and HOD in Asian Institute of Medical Sciences, Faridabad, Haryana; Dr. Namrata Seth MBBS, DGO, DNB, is Associate Consultant in Asian Institute of Medical Sciences, Faridabad, Haryana; Dr. Deepti Rastogi MBBS, DGO, is secondary DNB student in Asian Institute of Medical Sciences, Faridabad.
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Kant, A., Seth, N. & Rastogi, D. Comparison of Outcome of Normal and High-Risk Pregnancies Based Upon Cerebroplacental Ratio Assessed by Doppler Studies. J Obstet Gynecol India 67, 173–177 (2017). https://doi.org/10.1007/s13224-016-0946-3
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DOI: https://doi.org/10.1007/s13224-016-0946-3