Middle Cerebral Artery–to–Uterine Artery Pulsatility Index Ratio and Cerebroplacental Ratio Independently Predict Adverse Perinatal Outcomes in Pregnancies at Term

Zhou, Shangcheng; Guo, Hongyan; Feng, Dan; Han, Xiaoqiang; Liu, Heng; Li, Mingqun

doi:10.1016/j.ultrasmedbio.2021.06.015

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Another similar study showed that a low MCA/UA PI ratio was associated with negative obstetric outcomes in pregnancies with preeclampsia [31]. Similar results were obtained in the study of Zhou et al in which they investigated MCA/UA ratios in term pregnant women, and it was suggested that MCA to UA ratios could help predict negative perinatal outcomes [32].…”

Section: Discussionsupporting

confidence: 70%

Middle cerebral artery to uterine artery pulsatility index ratios in pregnancy with fetal growth restriction regarding negative perinatal outcomes

Şirinoğlu

Atakir²,

Konal

et al. 2022

J Surg Med

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Background/Aim: Fetal growth restriction (FGR) causes a high risk of perinatal morbidity and mortality, and the timing of the correct delivery time decision remains controversial. Cerebroplacental ratio (CPR), umbilical artery, uterine artery (UA) and middle cerebral artery (MCA) Doppler studies are used to predict adverse perinatal outcomes in FGR. However, since there is insufficient reliability for each separately and together, the search for new methods continues. This retrospective study was conducted to determine the degree of neonatal morbidity in fetuses suspected of having FGR by evaluating the MCA to UA pulsatility index (PI) ratios together with frequently used Doppler examinations. Methods: This was a retrospective cohort study conducted in a single-center hospital with the approval of the Medical Institutional Ethics Committee. A total of 424 pregnant women admitted to a tertiary hospital and diagnosed with FGR between July 2020 and December 2021 who were informed and approved were included in the study. Gestational age was confirmed by first trimester sonographic measurements of pregnancy. All pregnant women were examined by Doppler USG and umbilical artery, mean UA, fetal MCA, ductus venosus, CPR (MCA/umbilical artery pulsatility index ratio) and cerebrouterine ratio (MCA/UA) PI values were measured. Negative perinatal outcomes were recorded as blood gas level of the newborn at 7.2 and below, Apgar score of 7 and below at the fifth minute, and needing neonatal intensive care (NICU). Adverse perinatal and postnatal outcomes were recorded and compared with Doppler findings. If there were no signs of a negative perinatal outcome, it was considered a positive outcome. If at least one of the symptoms of adverse perinatal outcomes was present, it was considered a negative outcome Results: Decreased CPR and decreased MCA to UA PI were significantly and positively associated with an increased likelihood of exhibiting negative perinatal outcomes in pregnancies with FGR (P < 0.001, P < 0.001, respectively). The receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off value for MCA to uterine artery PI was 1.41 to predict FGR with 57.37% sensitivity and 62.50% specificity (AUC: 0.629; 95% CI: 0.581–0.675). When the CPR cut-off value was taken as 1.2069, the sensitivity was 42.86% and the specificity 83.93% in predicting negative perinatal outcomes in CPR values below this value (P < 0.001). Conclusion: CPR is the most successful criterion in distinguishing between positive and negative perinatal outcomes. It has been demonstrated that the MCA to uterine artery PI ratio values after CPR can also be used for this distinction. MCA to UA PI ratio sensitivity was higher than CPR and umbilical artery. This situation shows that MCA to uterine artery PI ratio (alone or when evaluated together with PPV and NPV ratios) is a criterion that can be added to other Doppler examinations in predicting negative perinatal outcomes.

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Section: Discussionsupporting

confidence: 70%

Middle cerebral artery to uterine artery pulsatility index ratios in pregnancy with fetal growth restriction regarding negative perinatal outcomes

Şirinoğlu

Atakir²,

Konal

et al. 2022

J Surg Med

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“…Furthermore, it has been demonstrated that the third trimester of high-risk pregnancies is a critical time for uterine artery Doppler examination, which offers information on placental perfusion and foetal health, while umbilical artery Doppler primarily indicates placental health [9] . It's worth noting that the cerebro-uterine (CU) ratio, which represents vascular impedance between the MCA and uterine arteries, is a relatively novel concept and hasn't been widely examined [5] .…”

Section: Introductionmentioning

confidence: 99%

Fetal Middle Cerebral to Uterine Artery Pulsatility Indices Ratios in Preeclampsia versus Normal Pregnancy

Shedid,

Solaiman,

Mousa

et al. 2024

Evidence Based Women's Health Journal

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Objectives: To assess the predictive value of MCA/uterine artery pulsatility indices (PI) ratio in the third trimester of pregnancy for anticipating adverse pregnancy outcomes in women with preeclampsia, comparing it to the CPR (MCA/ umbilical artery PI ratio). Study Design: A prospective study. Patients and Methods: The research involved 50 preeclampsia cases and 50 healthy pregnancies or births that were more than 26 weeks old. All participants underwent comprehensive laboratory testing, comprising Urine analysis, CBC, liver function tests, and renal function testing. Additionally, ultrasonography examinations were carried out at Benha University Hospital during the study period. Results: In the preeclampsia group, the mean MCA PI, MCA/UTA, and MCA/Umbilical artery PI were lower, while the mean uterine and umbilical artery PI were higher in contrast to control group, and these differences were statistically significant. Negative newborn results, such poor APGAR scores, preterm birth, NICU admission, SGA, and neonatal death, were all more prevalent in the preeclamptic group in contrast to control group, with significant differences variations observed. MCA/UTA ratio in pregnancies with preeclampsia demonstrated its effectiveness as a valuable predictor of adverse neonatal outcomes. Conclusion:The Cerebro-Uterine (CU) ratio was notably different between the two groups, being less in preeclampsia cases in contrast to control group. Furthermore, it was significantly linked to poor neonatal results. in pregnancies affected by preeclampsia. The CU ratio displayed a commendable ability to predict adverse neonatal outcomes.

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The implications of exosomes in pregnancy: emerging as new diagnostic markers and therapeutics targets

et al. 2022

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Extracellular vehicles (EVs) are a heterogeneous group of cell and membranous particles originating from different cell compartments. EVs participate in many essential physiological functions and mediate fetal-maternal communications. Exosomes are the smallest unit of EVs, which are delivered to the extracellular space. Exosomes can be released by the umbilical cord, placenta, amniotic fluid, and amniotic membranes and are involved in angiogenesis, endothelial cell migration, and embryo implantation. Also, various diseases such as gestational hypertension, gestational diabetes mellitus (GDM), preterm birth, and fetal growth restriction can be related to the content of placental exosomes during pregnancy. Due to exosomes' ability to transport signaling molecules and their effect on sperm function, they can also play a role in male and female infertility. In the new insight, exosomal miRNA can diagnose and treat infertilities disorders. In this review, we focused on the functions of exosomes during pregnancy.

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Middle Cerebral Artery–to–Uterine Artery Pulsatility Index Ratio and Cerebroplacental Ratio Independently Predict Adverse Perinatal Outcomes in Pregnancies at Term

Cited by 3 publications

References 30 publications

Middle cerebral artery to uterine artery pulsatility index ratios in pregnancy with fetal growth restriction regarding negative perinatal outcomes

Middle cerebral artery to uterine artery pulsatility index ratios in pregnancy with fetal growth restriction regarding negative perinatal outcomes

Fetal Middle Cerebral to Uterine Artery Pulsatility Indices Ratios in Preeclampsia versus Normal Pregnancy

The implications of exosomes in pregnancy: emerging as new diagnostic markers and therapeutics targets

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