P21.06: Perinatal risk degree determination: the role of ductus venosus flow, cerebroplacental ratio and cardiothoracic ratio

Abstract

The purpose of the study was to learn a role of cerebro-placental ratio and cardiothoracic ratio in the degree of perinatal risk determination. Antenatal US examinations were performed in 1448 fetuses with a high perinatal risk. The study included Doppler assessment of placental profile and fetal cardiovascular profile. Pregnancy outcomes and neonatal status were studied. Postnatal results were classified as adverse general postnatal outcome which meant perinatal or infant death and adverse clinical postnatal outcome which meant perinatal acidemia, Apgar score of 0–4 points, persistent pathological condition of the newborn. All the fetuses of the studied cohort were divided into two clinical groups: 638 fetuses with poor general postnatal outcome and/or clinical postnatal outcome (I group) and 810 fetuses with favourable clinical postnatal outcome (II group). The most significant differences occurred at the frequency of registration ductus venosus (DV) a-reverse wave, p<0.01. The increased cardio-thoracic ratio (CTR) occurred in fetuses of group I 9 times more frequent than of group II. The cerebroplacental ratio (CPR) reduction occurred 18 times, the prevalence of reverse flow component of the fetal aortic isthmus 6,2 times and the deepening of ductus venosus myocardial isovolumetric relaxation phase in the group I were registered 21 times more often than in group II, however these differences did not have statistical significance due to the small number of observations. Taking into account the limited possibilities of single centre study should be considered as necessary further multicentre studies of the role of fetal CTR and CPR as predictors of adverse pregnancy outcomes, in order to include these aspects in obstetrical management protocols of high perinatal risk fetuses monitoring to determine the perinatal risk degree ant to choose the best point for delivery.