Clinical significance of cerebro-placental ratio in antenatal surveillance

Ganju, Sunite A; Sood, Nishi; Jobta, Anupam

doi:10.33545/gynae.2020.v4.i3d.606

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…This finding was comparable to the statistically significant relation noted by Singh et al, 2013 [18] with 61.5% caesarean deliveries in their study though. Furthermore, Ganju, 2020 [19] reported that abnormal CPR is significantly associated with caesarean delivery (p value=0.001). Gruettner and his co-workers, 2019 [13] found that in their cases 41.2% of the patients had a spontaneous delivery, whereas 9.6% had a vaginal operative delivery and 49.3% underwent a cesarean section.…”

Section: Discussionmentioning

confidence: 99%

Cerebroplacental Ratio on Doppler as a Predictor of Fetuses at Risk of Perinatal Complications

Elraey

Elnamoury

Othman

et al. 2021

JAMMR

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Background: Doppler velocimetry is the best method of surveillance for fetal hypoxemia during pregnancy. Cerebroplacental ratio (CPR), has been suggested as a useful clinical simplification. It is believed that the CPR better predicts adverse perinatal outcomes than its individual components and better than conventional anthropometric models. Therefore, the aim of this study is to evaluate the significance of the cerebroplacental 10th centile threshold measured weekly from 36 weeks of gestation till delivery as a screening test for prediction of need for Cesarean section for intrapartum fetal compromise and the adverse neonatal outcome in women with normally grown fetuses and uncomplicated pregnancy. Methods: This study was carried out on 40 pregnant women uncomplicated, singleton pregnancy with appropriately grown fetuses on clinical assessment. The last Doppler indices including cerebroplacental ratio measurement obtained before labor was reported. CPR values below 1.1 were reported as abnormal. Various studies have variably defined the threshold of abnormal CPR ratio as <1.08. Results: There was significant decrease in the Mean of CPR among patients who had anemia compared to those without anemia. In addition, there was no significant association seen between low CPR and having previous history of abortion or IUGR as well as being a smoker. There was no significant difference between cases who had normal and abnormal CPR regarding gestational age at delivery. There was no difference between cases who had normal and abnormal cerebroplacental ratio regarding mode of delivery. there was significant decrease in the prevalence of low birth weight among group who had CPR≥1.08. CPR <1.08 was significantly associated with neonatal complication like NICU admission, and neonatal death. There was no statistically significant relationship between cerebroplacental ratio and neonatal complication like IUFD, and neonatal sepsis. There was no statistically significant association between the mean cerebroplacental ratio and IUFD. There was statistically significant association between the mean cerebroplacental ratio and NICU. There was no statistically significant association between the mean cerebroplacental ratio and neonatal sepsis. The mean cerebroplacental ratio of 0.93± 0.22 has a significant association with neonatal death. Conclusion: A low cerebroplacental ratio reflects redistribution of the cardiac output to the cerebral circulation and has been shown to improve accuracy in predicting adverse outcome compared with Middle cerebral artery (MCA) or Umbilical artery (UA) Doppler alone. Therefore, integrating CPR in clinical management may help to better identify fetuses at risk for adverse perinatal events, since abnormal CPR has been associated with an increased risk of perinatal complications.

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Section: Discussionmentioning

confidence: 99%

Cerebroplacental Ratio on Doppler as a Predictor of Fetuses at Risk of Perinatal Complications

Elraey

Elnamoury

Othman

et al. 2021

JAMMR

View full text Add to dashboard Cite

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Cerebro placental ratio at 30–34 weeks’ gestation in the prediction of perinatal outcome in low-risk and high-risk pregnancy

Jaiprakash

Sujani²,

Urvashi³

et al. 2022

IJOGR

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Doppler ultrasound velocimetry of umbilical and fetal vessels has become an established method of antenatal monitoring, allowing the non-invasive assessment of neonatal circulation. Cerebro placental ratio (CPR) is emerging as a significant predictor of adverse pregnancy outcome. To predict perinatal outcome in low and high-risk pregnancy in early and late-onset FGR using CPR. The study group comprised 410 pregnant women at 30-34 weeks, evaluated with ultrasound Doppler study, and other routine investigations and CPR were calculated. Women were categorized into high-risk and low-risk pregnancies and followed up until delivery, and fetal outcome was noted. Period of prolongation of pregnancy was significantly lower with high-risk patients than low-risk patients (31.09 ± 13.9 vs 37.79 ± 15.1, p=0.0003). NICU admissions significantly increased with high-risk patients than low-risk patients (22.22% vs 9.4%, p=0.002). Low-risk patients underwent significantly more vaginal deliveries as compared to high-risk patients (74.22% vs 44.87%, p < 0.0001). Birth weight, period of prolongation of pregnancy, and gestation period were significantly lower in patients with abnormal CPR than normal CPR group (2.82 Kg vs 1.94 Kg, 37.56 weeks vs 14.64 weeks, 266.47 days vs 245.41 days, respectively). Doppler velocimetry becomes an important tool for high-risk cases and late-onset mild FGR(after 32 weeks). CPR is helpful in high-risk pregnancies and also to predict peripartum fetal distress.

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Clinical significance of cerebro-placental ratio in antenatal surveillance

Cited by 2 publications

References 16 publications

Cerebroplacental Ratio on Doppler as a Predictor of Fetuses at Risk of Perinatal Complications

Cerebroplacental Ratio on Doppler as a Predictor of Fetuses at Risk of Perinatal Complications

Cerebro placental ratio at 30–34 weeks’ gestation in the prediction of perinatal outcome in low-risk and high-risk pregnancy

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