scholarly journals Umbilical and fetal middle cerebral artery Doppler at 30-34 weeks' gestation in the prediction of adverse perinatal outcome

2015 ◽  
Vol 45 (4) ◽  
pp. 409-420 ◽  
Author(s):  
S. Bakalis ◽  
R. Akolekar ◽  
D. M. Gallo ◽  
L. C. Poon ◽  
K. H. Nicolaides
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Adverse Perinatal Outcome

scholarly journals Correlation of efficacy of cerebro placental ratio with adverse perinatal outcome in clinically suspected IUGR pregnancies

2018 ◽  
Vol 7 (5) ◽  
pp. 1808
Author(s):  
Geeta Singh ◽  
Neerja Gupta ◽  
Sangeeta Singhal ◽  
Pramod Kishor Sharma
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Pulsatility Index ◽  
Umbilical Artery ◽  
Doppler Velocity ◽  
Wave Form ◽  
Adverse Perinatal Outcome ◽  
Diastolic Flow ◽  
Ultrasound Evaluation

Background: IUGR is a most common and complex problem in modern obstetrics. Most commonly use methods to assess fetal condition are BPP and NST which are not sensitive for predicting better perinatal outcome.  Present study was an effort to evaluate the role of ratio of pulsatility index (PI) of middle cerebral artery and umbilical artery which is called cerebro placental ratio as the most sensitive, specific and accurate predictor of adverse perinatal outcome in clinically suspected IUGR Pregnancies.Methods: 50 clinically suspected IUGR Pregnancies attending antenatal clinics Muzaffarnagar Medical College and Hospital, Muzaffarnagar were subjected to Doppler ultrasound evaluation Doppler velocity wave form of umbilical artery and fetal middle cerebral artery were obtained. Pulsatility index ratio of MCA and umbilical artery (cerebro placental ratio) was evaluated in each case. Abnormal ratio is defined as CPR<1.08 considered as cut of value. Ratio was coo related clinically with perinatal outcome.Results: Out of 50 antenatal cases, 63% neonates had birth weight <2.5 kg. There were 6 IUD’S and 44 live births, 9 neonates were admitted to NICU, 7 neonates had 5 min. APGAR score <7 and 13 neonates were born by emergency CS. Of the 6 IUDS, 4 cases had reversal of blood flow umbilical artery and 2 cases had absent diastolic flow. In all cases of reversal Diastolic flow, IUD occurred within 7 days of diagnosis. Conclusions: CPR is the most sensitive, specific and accurate parameter in prediction of adverse perinatal outcome and thus can help in decreasing perinatal mortality.

scholarly journals Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis

2018 ◽  
Vol 51 (3) ◽  
pp. 313-322 ◽  
Author(s):  
C. A. Vollgraff Heidweiller-Schreurs ◽  
M. A. De Boer ◽  
M. W. Heymans ◽  
L. J. Schoonmade ◽  
P. M. M. Bossuyt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Meta Analysis ◽  
Adverse Perinatal Outcome ◽  
Prognostic Accuracy ◽  
Cerebroplacental Ratio

scholarly journals Role of Ultrasonography in Screening High Risk Mothers for Detection of IUGR

2021 ◽  
Vol 8 (11) ◽  
pp. 106-112
Author(s):  
Gattani Chandrashekhar M ◽  
Reddy Pradeep
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Growth Restriction ◽  
Adverse Perinatal Outcome ◽  
Diastolic Flow ◽  
Foetal Monitoring ◽  
The Impact

Introduction: The 10th percentile of expected foetal weight for gestational age is classified as intrauterine growth restriction (IUGR) or foetal growth restriction. IUGR occurs for a variety of reasons. Any issue with the placenta is a major contributor. Aims and objectives: 1) To determine the role of ultrasonography in screening high risk mothers for detection of IUGR. 2) To find out the impact of fetal parameters on the extent of IUGR.3) For correlation between sonographic pattern of IUGR and the birth weight. 4) For correlation between doppler parameters and perinatal outcome. Materials and methods: This is a prospective study done over a period of 2 years in Mamata General Hospital (MGH) from Oct 2017 to Oct 2019. Study included 50 pregnant women with high risk factors and clinically suspected IUGR attending for ultrasound examination were subjected to Uterine, Umbilical and Middle cerebral artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria. Results: Reverse, absence or slow end diastolic flow was considered abnormal which was seen in 33 patients. Nine patients had Absent /Reversed end diastolic flow of which, 3 patients had IUD, 4 had Still births, 2 were admitted in NICU with apgar at 1min <7. Middle cerebral artery was abnormal in 10 patients, of which 8 patients had IUGR babies with adverse perinatal outcome. MCA/UA S.D ratio, which was abnormal in 19 patients of which 16 patients had adverse perinatal outcome. Conclusion: Doppler has proven to be more sensitive than other methods of foetal monitoring in recognising fetal compromises early and assisting in the proper time of delivery. Keywords: Ultrasonography, doppler, IUGR.

scholarly journals Importance of Doppler study of Umbilical Artery and FoetalMiddle Cerebral Artery in PIH and IUGR

2022 ◽  
Vol 8 (1) ◽  
pp. 287-295
Author(s):  
Manjunath G N
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Resistance Index ◽  
Optimal Time ◽  
Predictive Values ◽  
Placental Perfusion ◽  
Adverse Perinatal Outcome ◽  
Doppler Study

Background: PIH is associated with increased vascular resistance and decreased utero -placental perfusion resulting in an increased incidence of foetal hypoxia and impaired foetalgrowth.The objective of this study was to assess the diagnostic performance of S/D ratio, resistance index(RI), pulsatility index (PI) and cerebro-placental ratio (CPR) in the prediction of adverse perinatal outcome in PIH and IUGR. Objective: is to determine S/D ratio, RI, PI, CPR and asses their diagnostic values in the prediction of adverse perinatal outcome.Material& Methods:50 pregnant patients with PIH and IUGR, beyond 28 weeks of gestation, were prospectively studied at P k das institute of medical college,vaniyamkulamand subjected for Doppler study of the umbilical artery and foetal middle cerebral artery. The abnormality of above parameters was correlated with the major adverse perinatal outcome.Results:Patients with abnormal Doppler parameters had a poor perinatal outcome, compared to those who had normal Doppler study. The cerebro-placental ratios(CPR) had the sensitivity and specificity, positive and negative predictive values of 95%,76%,73%,95% respectively with Kappa value of o .68(good agreement) and p value of .000 which was statistically significant, for the prediction of major adverse perinatal outcome.Conclusions:This study shows that Doppler study of umbilical and foetal middle cerebral artery can reliably predict the neonatal morbidity and helpful in determining the optimal time of delivery in complicated pregnancies. The CPR is more accurate than the independent evaluation of S/D, RI, PI, in identifying foetus with adverse perinatal outcome.

scholarly journals Cerebro-umbilical doppler ratio as a predictor of adverse perinatal outcome

2020 ◽  
Vol 9 (2) ◽  
pp. 710
Author(s):  
A. Esther Kamalarani ◽  
Sheba Rosette Victor
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Serial Measurement ◽  
Non Invasive ◽  
Adverse Perinatal Outcome ◽  
Timely Delivery

Background: Intrauterine growth restriction (IUGR) is defined as a subnormal bodyweight or mass in utero. Fetal Doppler studies have been identified as one of the reliable and non-invasive methods of antepartum fetal surveillance in growth-restricted fetuses to detect hypoxemia and to plan timely delivery to precede acidemia. The aim of this study is to evaluate the screening efficacy of the pulsatility indices (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and the ratio of these two indices in predicting the adverse perinatal outcome in pregnancies complicated by IUGR.Methods: In this study patients were included after diagnosed to have fetal growth restriction clinically by a disparity of four weeks or more between symphysis-fundal height and gestational age and on the serial measurement of symphysis-fundal height after 30 weeks of gestation.Results: Out of 100 patients who fulfilled the criteria for the study, only 85 patients delivered. Out of them, only 16 women (18.8%) had a ratio of <1.08 which was considered abnormal and the rest of the women (81.2%) had a ratio >1.08 which was considered normal. The specificity for the Cerebro-umbilical ratio (<1.08) to predict adverse perinatal outcome was 96% whereas that for PI of umbilical A (>1.12) was 83% and that for the PI of middle cerebral A (<1.2) was 84%. However, the sensitivities for these indices were very low.Conclusions: The ratio of the pulsatility indices of the umbilical artery and middle cerebral artery is useful to predict the adverse perinatal outcome.

scholarly journals Role of doppler in the middle cerebral artery in prediction of fetal distress during labor in uncomplicated pregnancies at 40 weeks and beyond

2020 ◽  
Vol 69 (1) ◽  
pp. 63-72
Author(s):  
Nikolay N. Rukhlyada ◽  
Vyacheslav M. Bolotskikh ◽  
Elvira R. Semyonova ◽  
Olga A. Klitsenko
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Fetal Distress ◽  
Adverse Perinatal Outcome ◽  
Hypoxic Brain Damage ◽  
Uncomplicated Pregnancy ◽  
Cerebroplacental Ratio ◽  
Hypoxic Brain

The aim of this study was to reveal correlation between Doppler in the fetal middle cerebral artery and fetal decompensation during labor in uncomplicated pregnancies at 40 weeks and beyond. We by means of ultrasound Doppler examined 260 women at 40 to 42 weeks of uncomplicated pregnancy 48 hours before delivery, with fetal condition assessed subsequently during labor and immediately after delivery. We found out that in the group of women with caesarean section caused by fetal distress during labor, pulsatility indices in the middle cerebral artery evaluated just before labor were significantly lower than in the group of women whose fetus had better condition during labor. The same trend was observed when comparing Doppler velocimetry using the fetal cerebroplacental ratio. Moreover, we identified that in the group of women with newborns having Apgar 7 and less, middle cerebral artery measured less than 48 hours before delivery were lower than in the group of women having babies in better conditions. Furthermore, as result of this study, the trigger threshold for PI was found to be 0.835, below which fetuses have adverse perinatal outcome during labor. Thus, it was shown that Doppler in the fetal middle cerebral artery in uncomplicated pregnancies at 40 weeks and beyond could predict fetal distress and avoid hypoxic brain damage to the fetus during labor.

scholarly journals Role of obstetric Doppler in prediction of adverse perinatal outcome in intrauterine growth retardation

2017 ◽  
Vol 4 (2) ◽  
pp. 529
Author(s):  
Chirtrarasan P. ◽  
Kanagarameswarakumaran S.
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Meconium Aspiration Syndrome ◽  
Ductus Venosus ◽  
Optimal Time ◽  
Intrauterine Death ◽  
Intrauterine Growth ◽  
Adverse Perinatal Outcome

Background: Objective of current study was to determine and compare accuracy of various Doppler parameters for perinatal outcome. Umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) for predicting adverse perinatal outcome in patients of intrauterine growth retardation.Methods: 200 singleton pregnancies between 34 to 36 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery and ductus venosus.  Patients kept under surveillance till confinement. According to increasing severity of Doppler indices categorized the cases into six grades from grade 0 to grade 5.Results: Out of 200 cases, 169 were live born and 24 were neonatal death. There were 5 cases of intrauterine death of foetuses and 2 were still born. Out of the live born 32 had increased perinatal morbidity like poor APGAR score, development of necrotizing enterocolitis, hypoxic ischemic encephalopathy, meconium aspiration syndrome, hyperbilirubinemia, and prolonged admission in neonatal care unit for reasons like sepsis / birth asphyxia.Conclusions: Absent end diastolic flow (EDF) / reversal in umbilical artery had high positive predictive value in predicting adverse foetal outcome. Ductus venosus changes seem to be an ominous sign of a severely compromised foetus with poor perinatal outcome. Doppler investigation of the MCA, UA and DV plays an important role in monitoring the compromised foetuses and helps to determine the optimal time of delivery.

Middle Cerebral Artery-to-Uterine Artery Pulsatility Index Ratio Independently Predicts Adverse Perinatal Outcome in Pregnancies at Term

2020 ◽  
Author(s):  
Sufen Zhou ◽  
Hongyan Guo ◽  
Heng Liu ◽  
Mingqun Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Middle Cerebral Artery ◽  
Perinatal Outcome ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Adverse Perinatal Outcome ◽  
Independent Risk Factors

Abstract Background: This study aimed to investigate potential predictors, including cerebroplacental ratio (CPR), middle cerebral artery (MCA)/uterine artery pulsatility index (PI) ratio, for adverse perinatal outcome in pregnancies at term.Methods: This was an observational, prospective study of recruited pregnancies at term. An adverse perinatal outcome was set as the primary observational endpoint. The receiver operating characteristic (ROC) curve was plotted to investigate the predictive and cut-off values of risk factors for adverse perinatal outcome. Independent risk factors (maternal, neonatal, prenatal ultrasound and Doppler variables) for adverse perinatal outcome were evaluated by the univariate and multivariate logistic regression analyses.Results: A total of 392 pregnancies at term were included and 19.4% of them had suffered adverse perinatal outcome. CPR (OR: 0.42, 95%CI: 0.20-0.93, P=0.032) and MCA/uterine artery PI ratio (OR: 0.25, 95%CI: 0.16-0.42, P=0.032) were two independent risk factors for adverse perinatal outcome by univariate and multivariate logistic regression analyses.Conclusions: MCA/uterine artery PI ratio is a good predictor of adverse perinatal outcome in pregnancies at term.

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