Umbilical and fetal middle cerebral artery Doppler at 30–34 weeks' gestation in the prediction of adverse perinatal outcome

Abstract

Objective To investigate the potential value of cerebroplacental ratio (CPR) at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Methods

A possible new approach in the prediction of late gestational hypertension

“…However, in contrast to other studies, the ultrasound predictors in this study were assessed earlier, thus at 29 to 32 weeks’ gestation and not at 30 to 34 weeks’ gestation, [32–34,37,38] and it is known that it is easier to predict the negative outcomes closer to the time when the predictors have been assessed. [40] Therefore, the low detection rate at 10% false positive rate was probably partly due to the early assessment of predictors than in previously published studies.…”

“…In previous published studies, about third-trimester screening of pregnancies complications and adverse perinatal events, sFlt-1 was considered but aIMT never before. [32–34,37,38] The validated models all included UtA Doppler measures or biomarkers that require laboratory testing that is not currently part of routine practice and is too expensive for use in low- or middle-income countries. [39] …”

A Low Cerebroplacental Ratio at 20-24 Weeks of Gestation Can Predict Reduced Fetal Size Later in Pregnancy or at Birth

“…These observations led to the evaluation of the CPR as a screening tool for pregnant women during the third trimester of pregnancy to identify fetuses at risk of late SGA, 5962 stillbirth, low pH in the umbilical cord, low Apgar scores, cesarean delivery for fetal distress, and admission to the neonatal intensive care unit. 60–62 .…”

Calculation of fetal cerebroplacental ratio multiples of the median: are all methods equivalent?

“…We read with interest the recent articles by Akolekar et al 1 and Bakalis et al 2 . The authors converted Doppler values into multiples of the median (MoM) in order to evaluate the contribution of maternal variables to third-trimester fetal cerebroplacental ratio (CPR) 1 and the importance of CPR at 30-34 weeks in the explanation of adverse perinatal outcome 2 .…”

“…The authors converted Doppler values into multiples of the median (MoM) in order to evaluate the contribution of maternal variables to third-trimester fetal cerebroplacental ratio (CPR) 1 and the importance of CPR at 30-34 weeks in the explanation of adverse perinatal outcome 2 . One issue that caught our attention was that in both cases the authors defined the CPR MoM as the ratio between the middle cerebral artery pulsatility index (PI) MoM and the umbilical artery PI MoM, i.e.…”