Role of Cerebro-Placental Doppler Ratio in prediction of perinatal outcome in Intrauterine Growth Restriction

Document Type : Original Article

Author

Associate professor Department of Obstetrics and Gynaecology Mansoura University Hospital Mansoura Facult

Abstract

Background: The Doppler examination of fetal and maternal blood vessels is one of the most important evaluation tools of the blood supply to the embryo specially when
intrauterine growth restriction(IUGR) diagnosed during
intrauterine life. We conducted an observational study to
assess the role of Cerebro-Placental Doppler Ratio (CPR)
in prediction of adverse perinatal outcome of IUGR.
Methods: This prospective observational cohort study was
conducted at Mansoura University Hospital-department
of obstetrics and gynecology among 100 pregnant women
diagnosed with IUGR. We performed two-dimensionalultrasound examination of fetus and placenta associated with
Doppler waveform analysis of umbilical and middle cerebral arteries (UA & MCA). Estimation of CPR was performed by the following equation (MCA pulsatility index/
UA pulsatility index).
Results: We divided our patients into two groups either
with CRP <1 or with CRP ≥1.An emergencycesarean delivery (CD) was the dominant mode of delivery in 66.7%
of cases with CPR<1, versus 35.4% in cases with CPR≥1.
There was no statistically significant difference between
both groups in the mean gestational age at delivery
(35.38±1.53 & 36.15±1.77p=0.07) respectively. The mean
neonatal weightswere (1497.6±227.2 gm& 1813.9±304.76
gm p < 0.001) in both groups respectively. All neonates with
CPR<1were bornewith Apgar score< 7 at 5 minutes and
were admitted to neonatal intensive care units (NICU). Only 62% of neonates were admitted to NICU
when CPR was ≥1.
Conclusion: Data from our study showed
that the cutoff point for CPR is ≤1.1, and it
has95.5% sensitivity in predicting adverse
perinatal outcomes.


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