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. 2024 Feb 24;16(2):e54816.
doi: 10.7759/cureus.54816. eCollection 2024 Feb.

Role of Cerebroplacental Ratio in Predicting Perinatal Outcome

Abhay Kumar  1 , Anju Singh  1 , Snigdha Kumari  1 , S C Saha  1 , Tulika Singh  2 , Shiv Sajan Saini  3
Affiliations

Role of Cerebroplacental Ratio in Predicting Perinatal Outcome

Abhay Kumar et al. Cureus. .

Abstract

Objective Doppler velocimetry provides a sensitive, non-invasive, and safe method of surveillance of fetal hemodynamics and fetomaternal circulation. Cerebroplacental ratio (CPR) is an indicator of placental function and fetal maladaptation to placental insufficiency. Cerebroplacental ratio (CPR) is becoming a significant indicator of unfavorable pregnancy outcomes, which has implications for the assessment of fetal well-being. This study aimed to determine the cut-off value of the cerebroplacental ratio (CPR) in appropriate for gestational age (AGA) fetuses in high-risk mothers to predict adverse perinatal outcomes. We also compared the efficacy of CPR, umbilical artery pulsatility index (UmA PI), and middle cerebral artery pulsatility index (MCA PI) for predicting adverse perinatal outcomes. Design and setting This was a prospective observational study conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Methods A total of 100 women with singleton high-risk pregnancies were included in this prospective observational study. Obstetric ultrasound was performed at the time of recruitment, and fetal weight and CPR were noted. Based on fetal weight, patients were divided into AGA and fetal growth restriction (FGR) groups; CPR was measured; patients were followed up fortnightly; and outcomes were noted. Main outcome The effectiveness of CPR, UmA PI, and MCA PI for predicting poor perinatal outcomes and identifying the cut-off value of CPR in appropriate for gestational age (AGA) fetuses in high-risk mothers was assessed. Result The values of MCA PI, UmA PI, and CPR were statistically significant between AGA and FGR (p-value =.023, .002 and .0001), respectively. The cut-off value for CPR-detecting adverse outcomes in AGA was 1.49. It has sensitivity, specificity, positive predictive value, and negative predictive value of 67.5%, 68%, 71.69%, and 70.21%, respectively. Conclusion Cerebroplacental ratio (CPR) reflects both circulatory insufficiency of the placenta and adaptive changes of the middle cerebral artery, indicating an important non-invasive surveillance modality.

Keywords: cerebroplacental ratio; high-risk pregnancy; middle cerebral artery doppler; perinatal outcome; umbilical artery doppler.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Recruitment of patients in the study
Figure 2
Figure 2. Cut-off value of CPR in AGA in predicting adverse outcomes
AGA: appropriate for gestational age; CPR: cerebroplacental ratio
Figure 3
Figure 3. Comparison of CPR, MCA PI, and UmA PI in the AGA fetus in predicting adverse outcomes
CPR: cerebroplacental ratio; MCA PI: middle cerebral artery pulsatility index; UmA PI: umbilical artery pulsatility index
Figure 4
Figure 4. Overall comparison of CPR, MCA PI, and UmA PI in predicting adverse outcomes.
CPR: cerebroplacental ratio; MCA PI: middle cerebral artery pulsatility index; UmA PI: umbilical artery pulsatility index
See this image and copyright information in PMC

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