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

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 whenintrauterine growth restriction(IUGR) diagnosed duringintrauterine life. We conducted an observational study toassess the role of Cerebro-Placental Doppler Ratio (CPR)in prediction of adverse perinatal outcome of IUGR.Methods: This prospective observational cohort study wasconducted at Mansoura University Hospital-departmentof obstetrics and gynecology among 100 pregnant womendiagnosed with IUGR. We performed two-dimensionalultrasound examination of fetus and placenta associated withDoppler 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 eitherwith 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 betweenboth groups in the mean gestational age at delivery(35.38±1.53 & 36.15±1.77p=0.07) respectively. The meanneonatal weightswere (1497.6±227.2 gm& 1813.9±304.76gm p < 0.001) in both groups respectively. All neonates withCPR<1were bornewith Apgar score< 7 at 5 minutes andwere admitted to neonatal intensive care units (NICU). Only 62% of neonates were admitted to NICUwhen CPR was ≥1.Conclusion: Data from our study showedthat the cutoff point for CPR is ≤1.1, and ithas95.5% sensitivity in predicting adverseperinatal outcomes.