Predictive value of middle cerebral artery to uterine artery pulsatility index ratio in preeclampsia

Eser, Ahmet; Zülfikaroğlu, Ebru; Eserdağ, Süleyman; Kılıç, Sevtap; Danışman, Nuri

doi:10.1007/s00404-010-1660-5

Cited by 29 publications

(33 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, abnormal CU ratio was present in 38/95 (40%) cases and abnormal CP ratio (brain sparing) was seen in 21/95 (22%) cases. The mean gestational age of delivery was comparable with that of a study done by as Eser et al which indicates that gestational age at delivery was significantly lower in group with abnormal CU ratio [8]. When CU ratio was abnormal, SGA was present in 47.4% (18/38) babies and AGA in 52.6% (20/38) babies.…”

Section: Discussionsupporting

confidence: 83%

“…Simanaviciute and Gudmundsson found no significant correlation between abnormal CU ratio and poor Apgar score [3]. Similar finding was noted in a study by Eser et al [8]. …”

Section: Discussionsupporting

confidence: 71%

“…Thus, abnormal CU ratio could not be directly attributed to preterm delivery. In Eser et al study, CU ratio was independently associated with delivery before 37 weeks, whereas CP ratio was not [8]. …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Predictive Value of Middle Cerebral Artery to Uterine Artery Pulsatility Index Ratio in Hypertensive Disorders of Pregnancy

Adiga

Kantharaja

Hebbar

et al. 2015

International Journal of Reproductive Medicine

View full text Add to dashboard Cite

Aims and Objectives. (i) To determine the predictive value of cerebrouterine (CU) ratio (middle cerebral artery to uterine artery pulsatility index, MCA/UT PI) in assessing perinatal outcome among hypertensive disorders of pregnancy. (ii) To compare between CU ratio and CP ratio (MCA/Umbilical artery PI) as a predictor of adverse perinatal outcome. Methods. A prospective observational study was done in a tertiary medical college hospital, from September 2012 to August 2013. One hundred singleton pregnancies complicated by hypertension peculiar to pregnancy were enrolled. Both CU and CP ratios were estimated. The perinatal outcomes were studied. Results. Both cerebrouterine and cerebroplacental ratios had a better negative predictive value in predicting adverse perinatal outcome. However, both CU and CP ratios when applied together were able to predict adverse outcomes better than individual ratios. The sensitivity, specificity, positive predictive value, and the negative predictive values for an adverse neonatal outcome with CU ratio were 61.3%, 70.3%, 56%, and 78.9%, respectively, compared to 42%, 57.5%, 62%, and 76% as with CP ratio. Conclusion. Cerebrouterine ratio and cerebroplacental ratio were complementary to each other in predicting the adverse perinatal outcomes. Individually, both ratios were reassuring for favorable perinatal outcome with high negative predictive value.

show abstract

Section: Discussionsupporting

confidence: 83%

“…Simanaviciute and Gudmundsson found no significant correlation between abnormal CU ratio and poor Apgar score [3]. Similar finding was noted in a study by Eser et al [8]. …”

Section: Discussionsupporting

confidence: 71%

See 1 more Smart Citation

Predictive Value of Middle Cerebral Artery to Uterine Artery Pulsatility Index Ratio in Hypertensive Disorders of Pregnancy

Adiga

Kantharaja

Hebbar

et al. 2015

International Journal of Reproductive Medicine

View full text Add to dashboard Cite

show abstract

“…Briefly, absent or reversed end‐diastolic velocity in the UA is strongly associated with perinatal morbidity/mortality. Reduced MCA‐PI < 10 th percentile is a sign of brain vasodilatation and has been associated with emergency Cesarean delivery due to non‐reassuring fetal heart rate in growth‐restricted fetuses. CPR < 10 th percentile is considered to be a sign of hemodynamic redistribution, can be observed even before the UA is affected and is an indicator for close fetal surveillance.…”

Section: Use Of Ultrasound In Patients With Established Pre‐eclampsiamentioning

confidence: 99%

ISUOG Practice Guidelines: role of ultrasound in screening for and follow‐up of pre‐eclampsia

Sotiriadis

Hernández‐Andrade

Costa

et al. 2018

Ultrasound in Obstet & Gyne

143

115

View full text Add to dashboard Cite

RESUMEN Pautas de práctica de ISUOG: la función del ultrasonido en la detección y seguimiento de la preeclampsia Introducción La hipertensión en el embarazo afecta hasta el 10% de las mujeres embarazadas y la incidencia global combinada de la preeclampsia (PE) es de aproximadamente el 3%. Las diferencias significativas entre los países desarrollados y en desarrollo pueden atribuirse a diferencias reales o a diferencias derivadas de la adquisición de datos. La PE y sus complicaciones contribuyen en gran medida a la morbilidad y mortalidad materna y perinatal en todo el mundo. Dado que la atención oportuna y efectiva puede mejorar los resultados de la PE, el desarrollo de estrategias eficaces de predicción y prevención ha sido uno de los principales objetivos de la atención prenatal y de la investigación. La PE es una enfermedad multisistémica de origen multifactorial: está relacionada con placentación defectuosa, estrés oxidativo, autoinmunidad, activación de plaquetas y trombina, inflamación intravascular, disfunción endotelial, desequilibrio en la angiogénesis y mala adaptación cardíaca materna. La invasión defectuosa de la placenta está fuertemente asociada con la mayoría de los casos de PE temprana y grave. En contraste, la placentación defectuosa parece ser menos importante para el desarrollo de la PE que se manifiesta más tarde en el embarazo, por ejemplo después de las 34 semanas. En comparación con los embarazos afectados por la enfermedad de aparición temprana, en aquellos complicados con PE a término o cerca de este, la frecuencia de anomalías histológicas de las placentas es significativamente menor, y los factores maternos (p. ej. el síndrome metabólico o la hipertensión crónica) tienen una importancia relativamente mayor. También se observan diferencias entre la PE de aparición temprana y la de aparición tardía en los factores de riesgo, la capacidad de respuesta vascular materna, el rendimiento del cribado y la eficacia de la prevención. El conocimiento cada vez mayor sobre la fisiopatología de la PE se refleja en las estrategias de cribado actuales, que se basan en el historial, la demografía, los biomarcadores (como la presión arterial) y el Doppler de la arteria uterina. Actualmente hay más de 10 000 artículos de PubMed relacionados con la detección de la PE, lo que indica el gran interés en este tema. Menos de una quinta parte de estos se refieren a la detección temprana, lo que constituye un avance de la última década. El objetivo de estas Pautas es revisar la evidencia más reciente y, en lo posible, proporcionar recomendaciones basadas en la evidencia con respecto a la función del ultrasonido en el cribado y seguimiento de la PE. Las Pautas se centran en los aspectos técnicos y clínicos del cribado, sin incluir los aspectos económicos y políticos de la salud, como la conveniencia y la rentabilidad del cribado. Además, estas Pautas se elaboraron partiendo del supuesto de que se dispone de los recursos necesarios para la realización del cribado y el seguimiento (equipo, examinadores y conocimient...

show abstract

“…The clinical value of diagnosing BSF in fetuses with intrauterine growth restriction (IUGR) is controversial. Some studies support the value of diagnosing BSF in clinical management (1–4), whereas critics argue that the presence of BSF has a poor predictive value on perinatal outcome (5,6), and in the absence of BSF one never knows whether a transient BSF has first appeared (7).…”

Section: Introductionmentioning

confidence: 99%

Relations between fetal brain‐sparing circulation, oxytocin challenge test, mode of delivery and fetal outcome in growth‐restricted term fetuses

Olofsson

2010

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Objective. The study was designed as a prospective non‐interventional, observational study to elucidate the potential value of fetal middle cerebral artery Doppler velocimetry to identify brain‐sparing flow in a surveillance program for suspected intrauterine growth restriction (IUGR). Material and methods. The study was carried out at Skåne University Hospital, Malmö, Sweden. One hundred and twenty‐six single pregnancies suspected of IUGR at ≥36 gestational weeks were assessed. The main outcome measures were positive/negative oxytocin challenge test (OCT) and cesarean/vaginal delivery. The pregnancies were managed with ultrasound fetometry, uterine and umbilical artery Doppler flow velocimetry, nonstress test, and an OCT to decide the optimal time and mode of delivery. Cases with a positive OCT were promptly delivered by cesarean section, whereas negative cases were allowed a trial of labor. Middle cerebral artery Doppler flow velocimetry results were blinded to the managing obstetricians. Brain‐sparing flow was defined as a middle cerebral artery‐to‐umbilical artery pulsatility index ratio of <1.08. Nonparametric statistics with significance set at p < 0.05 were used, and Cohen's kappa coefficient was calculated for congruence of brain‐sparing flow with OCT and mode of delivery, respectively. Results. The positive predictive value and sensitivity figures of brain‐sparing flow to indicate a positive OCT and cesarean delivery were 33–63%. The inter‐rater reliability of brain‐sparing flow vs. positive OCT showed a kappa coefficient of 0.19, and brain‐sparing flow vs. cesarean section among OCT‐negative cases a kappa coefficient of 0.23. Conclusion. Fetal brain‐sparing flow is a poor predictor of a positive OCT, and of cesarean section in OCT‐negative cases.

show abstract

Predictive value of middle cerebral artery to uterine artery pulsatility index ratio in preeclampsia

Abstract: Our results suggest that MCA/uterine artery PI ratio is a good predictor of neonatal outcome in preeclamptic patients in the third trimester and could be used to identify fetuses at risk of morbidity and mortality.

Cited by 29 publications

References 22 publications

Predictive Value of Middle Cerebral Artery to Uterine Artery Pulsatility Index Ratio in Hypertensive Disorders of Pregnancy

Predictive Value of Middle Cerebral Artery to Uterine Artery Pulsatility Index Ratio in Hypertensive Disorders of Pregnancy

ISUOG Practice Guidelines: role of ultrasound in screening for and follow‐up of pre‐eclampsia

Relations between fetal brain‐sparing circulation, oxytocin challenge test, mode of delivery and fetal outcome in growth‐restricted term fetuses

Contact Info

Product

Resources

About