Value of third‐trimester cerebroplacental ratio and uterine artery Doppler indices as predictors of stillbirth and perinatal loss

Abstract

Objective Placental insufficiency contributes to the risk of stillbirth. Cerebroplacental ratio (CPR) is an emerging marker of placental insufficiency. The aim of this

Perinatal loss at term: role of uteroplacental and fetal Doppler assessment

“…In keeping with previous work by Khalil et al 5 , the findings of the current study confirm that significantly higher UtA resistance in the third trimester is associated with an increased risk of perinatal death. By performing regression analysis to determine the factors affecting the risk of perinatal death, we confirmed that UtA-PI, along with EFW, is associated significantly and independently with increased perinatal mortality.…”

“…More recent evaluation of this ultrasound parameter in the third trimester has suggested that abnormal UtA Doppler indices are also associated with an increased risk of adverse pregnancy outcome. In keeping with previous work by Khalil et al ,. the findings of the current study confirm that significantly higher UtA resistance in the third trimester is associated with an increased risk of perinatal death.…”

“…Fetal CPR has also been proposed as a predictor of adverse perinatal outcome and has been shown to be more sensitive than is UA or MCA Doppler assessment alone 31,32 . Fetal CPR measured in the third trimester is an independent and stronger predictor of stillbirth and perinatal mortality than is EFW 5 . In our study, CPR < 5 th centile was associated significantly with an increased risk of perinatal mortality, however, we did not find CPR MoM to be a significant independent predictor of adverse outcome.…”

Birth‐weight differences at term are explained by placental dysfunction and not by maternal ethnicity

“…Abnormal CPR values are associated with adverse perinatal outcome, including Cesarean section for fetal compromise, abnormal intrapartum monitoring, admission to the neonatal unit and perinatal mortality. A consequence of these associations is that fetuses affected by placental insufficiency at term may present with low CPR values regardless of their weight centile [11][12][13][14][15][16] .…”

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

“…When the fetuses were divided into two groups according to the CPR measurement, using the cut-off value suggested by Morales-Rosello et al 54 (< or ≥ 0.6765 MoM), those with a CPR below the cut-off had a significantly increased risk of cesarean delivery due to fetal distress. Khalil et al 56 reported that a low CPR, independent of the EFW, was associated with an increased prevalence of stillbirth, and perinatal mortality 57 . Similar results were reported by Triunfo et al 58 who showed that a low CPR in the third trimester of pregnancy had a higher association with adverse perinatal outcomes such as, nonreassuring fetal status requiring emergent cesarean section, 5-minute Apgar score <7, or neonatal metabolic acidosis at birth (UA pH ≤7.15 and base excess greater than 12 mEq/L) than EFW.…”