TY  - JOUR
T1  - Cerebroplacental Ratio as A Non‐invasive Predictor of Fetal Compromise in Hypertensive Pregnancies: Comparative Evaluation with Conventional Doppler Parameters
AU - Reddy, Pranadeep AU - Sridevi, M. 
JO  - Research Journal of Medical Sciences
VL  - 18
IS  - 11
SP  - 852
EP  - 856
PY  - 2024
DA  - 2001/08/19
SN  - 1815-9346
DO  - makrjms.2024.11.852.856
UR  - https://makhillpublications.co/view-article.php?doi=makrjms.2024.11.852.856
KW  - Cerebroplacental ratio
KW  - Hypertensive disorders of pregnancy
KW  - Doppler ultrasound
KW  - Perinatal outcome
KW  - Umbilical artery
AB  - Hypertensive disorders of pregnancy are major contributors to maternal
and perinatal morbidity and mortality worldwide. Doppler velocimetry
has emerged as a valuable non‐invasive tool for fetal surveillance, with
the cerebroplacental (CP) ratio integrating the effects of placental
resistance and fetal compensatory mechanisms. This study aimed to
evaluate the predictive value of the CP ratio for adverse perinatal
outcomes and compare it with the individual Doppler indices of the
umbilical artery (UA) and middle cerebral artery (MCA). This prospective
observational study included 114 pregnant women with hypertensive
disorders attending a tertiary care center. Detailed history, clinical
examination, and ultrasound Doppler assessments were performed,
measuring UA pulsatility index (PI), MCA PI, S/D ratios, and the CP ratio.
A CP ratio <1.08 was considered abnormal. Perinatal outcomes including
cesarean section for fetal distress, small‐for‐gestational‐age neonates,
APGAR scores, NICU admissions, and perinatal mortality were recorded.
Statistical analysis included calculation of sensitivity, specificity, positive
predictive value (PPV), negative predictive value (NPV), and chi‐square
testing. An abnormal CP ratio was observed in 32.5% of participants.
Significant associations were noted between abnormal CP ratio and
adverse perinatal outcomes, including cesarean section for fetal distress
(81.1%), small‐for‐gestational‐age neonates (70.3%), NICU admissions
(70.3%), and low APGAR scores at 1 and 5 minutes. The CP ratio
demonstrated superior predictive accuracy compared to S/D ratios of UA
and MCA, with a sensitivity of 60.34%, specificity of 100%, and diagnostic
accuracy of 77.19% for predicting composite adverse perinatal outcomes.
The cerebroplacental ratio is a superior non‐invasive marker for
predicting adverse perinatal outcomes in pregnancies complicated by
hypertensive disorders. Routine assessment of the CP ratio in antenatal
Doppler surveillance protocols could enhance early identification of
fetuses at risk and facilitate timely clinical intervention.
ER  -