Background/aim: For many years clinical research has been concerned with doppler sonography as a non-invasive tool for intrauterine fetal status assessment. A new focus is now placed on the measurement of cerebroplacental index (CPR) as a predictor of fetal outcome. Our aim was to investigate the relationship between the cerebroplacental ratio (CPR), the delivery mode and the fetal outcome in singleton pregnancies.
Patients And Methods: A retrospective cohort study of pregnancies in which doppler sonography of middle cerebral artery (MCA) and umbilical artery (UA) was conducted up to 9 weeks before delivery took place. Patients with pathological (CPR≤1.0) and normal CPR (>1.0) were compared by umbilical cord pH, APGAR scores, birth weight, delivery week and delivery mode.
Results: A total of 2,270 singleton pregnancies were included. The APGAR score for 1, 5 and 10 minutes and the gestational age at delivery were significantly lower in the group of patients with pathological CPR (p<0.001). Overall, 50% of the cohort had a cesarean section, the difference between the groups was statistically significant (p<0.001), with a higher amount of cesareans in the group of patients with pathological CPR. The multiple regression analysis showed a significantly improved pH of delivery when cesarean section (p<0.001), female sex of fetus (p=0.013) and higher CPR (p=0.035) were present.
Conclusion: The measurement of CPR is an important, non-invasive predictive parameter and leads to the identification of a risk collective even in the non-selected patient population and thus probably to a reduction of perinatal morbidity.
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http://dx.doi.org/10.21873/invivo.11659 | DOI Listing |
Sci Rep
December 2024
Department of Ultrasound, Yantai Yuhuangding Hospital, Yantai, Shandong, China.
To investigate the correlation between fetoplacental circulation and maternal left ventricular myocardial work (MW) parameters in patients with preeclampsia (PE) and the prediction of fetal hypoxia. Seventy-eight PE patients (PE group) were assigned to intrauterine-hypoxia (27) and non-intrauterine-hypoxia (51) groups, and 45 healthy pregnant women were controls. The receiver operating characteristic (ROC) curve evaluated the diagnostic efficacy of each parameter for fetal intrauterine hypoxia.
View Article and Find Full Text PDFJ Perinat Med
December 2024
Department of Obstetrics, University Hospital Jena, Jena, Germany.
Objectives: This study investigates the relationship between the cerebro-placental ratio (CPR) measured at 40+0 weeks' gestation and perinatal outcomes to determine a CPR cut-off that may justify induction of labor at term in appropriately grown fetuses (AGA). Although CPR is used for monitoring growth-restricted fetuses, its role in guiding labor induction decisions for AGA pregnancies at term remains unclear.
Methods: A retrospective cohort study was conducted using data from 491 singleton pregnancies with intended vaginal deliveries between 2015 and 2021.
J Pers Med
November 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
Physiol Res
November 2024
Department of Obstetrics and Gynecology, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA.
The fetus develops normally in a hypoxic environment but exaggerated hypoxia late in pregnancy is a worrisome sign often observed in hypertensive disorders of pregnancy, placental insufficiency, or fetal growth restriction (FGR). Serial fetal biometry and the cerebroplacental ratio (CPR, calculated as the middle cerebral artery [MCA] / the umbilical artery [UmbA] pulsatility indices [PI]), are commonly used to indicate fetal "brain sparing" resulting from exaggerated fetal hypoxia. But unclear is the extent to which a low CPR indicates pathology or is a physiological response for maintaining cerebral blood flow.
View Article and Find Full Text PDFGeburtshilfe Frauenheilkd
November 2024
Department of Gynecology and Obstetrics, TUM School of Medicine and Health, Technical University Munich (TUM), TUM University Hospital, Munich, Germany.
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