Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Abstract
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.
How to cite this article:
M. Sridevi and Pranadeep Reddy. Cerebroplacental Ratio as A Non‐invasive Predictor of Fetal Compromise in Hypertensive Pregnancies: Comparative Evaluation with Conventional Doppler Parameters.
DOI: https://doi.org/10.36478/makrjms.2024.11.852.856
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.11.852.856