Cerebroplacental Ratio in The Prediction of Adverse Perinatlal Outcome in Postdte pregnancy - A prospective study

Abstract BACKGROUND: Postdate pregnancies are associated with increased risk of fetal and maternal morbidity and mortality. The cerebroplacental ratio (CPR) is emerging as an important non-invasive tool to assess fetal wellbeing and predict adverse outcome in high risk pregnancies. The aim of this report was to evaluate the value of Doppler CPR in predicting adverse pregnancy outcome in the setting. METHOD: This was a prospective study of 97 pregnant women from 40 weeks of gestation. Fetal Doppler evaluation of the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) were done and the CPR calculated as MCA-PI/UA-PI. The women were followed up until delivery the following data collected: the Apgar score, birth weight and information about SCBU admission.RESULT: The women were aged 19 – 41 years (mean 30.22±4.8years) and the pregnancies were at 40 – 41+3 weeks. The mean UA-PI, MCA-PI and CPR were 0.83 ±0.16, 1.15±0.19 and 1.42 ± 0.31, respectively. Abnormal UA-PI, MCA-PI and CPR were associated with an increased risk of adverse perinatal outcome (relative risk of 4.72, 7.08 and 9.78 respectively). Abnormal UA-PI was associated with fetal distress, abnormal MCA-PI was associated with fetal distress, low Apgar score at 1minute and special care baby unit admission, and abnormal CPR was associated with fetal distress and low Apgar score at 1minute. CONCLUSION: CPR is a good predictor of adverse perinatal outcome in postdate pregnancy and is recommended as an adjunct in evaluation of fetal wellbeing in this setting and similar settings.