Role Of Middle Cerebral Artery / Umbilical Artery Pusatility Index Ratio (cerebro-placental ratio CPR) For Prediction Of Fetal Outcome In Preeclamptic Patients

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Sohag University, Egypt.

2 Department of Obstetrics and Gynecology, Faculty of Medicine , Sohag University, Egypt.

Abstract

Objective: The aim of this prospective observational study is to assess the accuracy of Doppler indices of umbilical and middle cerebral especially fetal middle cerebral artery/umbilical artery pulsatility index ratio during the third trimester in predicting acidemia and low Apgar score at 5 minutes after birth in neonates of women with preeclampsia. To provide basis for use of  Doppler tests in directing treatment protocol for preeclamptic patients.
Methods: Study design: Cohort observational study among women with preeclampsia.
Study setting: One hundred cases who were at 32 to 40 weeks of gestation with preeclampsia(from March 2017 to March 2018)  attended antenatal clinic and emergency room at obstetrics and gynecology department, faculty of medicine, Sohag University Hospital. Ultrasound was performed at fetal care unit at Sohag University Hospital.
Results: This observational cross-sectional study was designed to assess Doppler indices of umbilical artery as predictor of neonatal outcomes among women with preeclampsia.A total 100 pregnant women with preeclampsia were recruited in the study
Conclusion: We recommend adding MCA (PI)/ UA (PI) ratio to routine antepartum fetal surveillance from 32 weeks gestation for women with preeclampsia as there is a strong correlation between it and poor neonatal outcomes.

Keywords

Main Subjects


  1. Akolekar R, Sarno L, Wright A Wright D and Nicolaides KH.: Fetal middle cerebral artery and umbilical artery pulsatility index: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol, 2015; 45: 402-408.
  2. Alarm NE and Maarouf TM.: Cerebro placental Doppler indices ratio and perinatal outcome among high-risk pregnancy. Journal of American science, 2015; 11(6): p: 170-174.
  3. Asma AK, Morales-Rosello J, Morlando M, Hannan H, Bhide A, Papageorghiou A, Thilaganathan B.: Is fetal cerebroplacental ratio an independent predictor of intrapartum fetal compromise and neonatal unit admission? American J of Obst and Gyne, 2015; P1-10.
  4. Dewbury KC, Meire HB, Cosgrove DO and Farrant P. Doppler in obstetrics. In: clinical ultrasound: a comprehensive text-ultrasound in obstetrics and gynecology. Dewbury KC, Meire HB, Cosgrove DO and Farrant P (eds). 2nd ed. Churchill, Livingstone, London, 2001; 259-277.
  5. Ebrashy A, Azmy O, Ibrahim M, Waly M.: Middle cerebral/umbilical artery resistance index ratio as a sensitive parameter for fetal well-being and neonatal outcome in patients with preeclampsia: case-control study. Croat J Med J, 2005; 46(5): 826-831.
  6. El-Sokkary M, Omran M and Ahmed H.: Ratio of middle cerebral artery umbilical artery Doppler velocimetry and status of a newborn in post-term pregnancy. Br Med J, 2011; 280: 282-283.