scholarly journals Predictive Value of Middle Cerebral Artery to Uterine Artery Pulsatility Index Ratio in Hypertensive Disorders of Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Prashanth Adiga ◽  
Indumathi Kantharaja ◽  
Shripad Hebbar ◽  
Lavanya Rai ◽  
Shyamala Guruvare ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Perinatal Outcomes ◽  
Hypertensive Disorders Of Pregnancy ◽  
Adverse Perinatal Outcome ◽  
Hypertensive Disorders

Aims and Objectives. (i) To determine the predictive value of cerebrouterine (CU) ratio (middle cerebral artery to uterine artery pulsatility index, MCA/UT PI) in assessing perinatal outcome among hypertensive disorders of pregnancy. (ii) To compare between CU ratio and CP ratio (MCA/Umbilical artery PI) as a predictor of adverse perinatal outcome.Methods. A prospective observational study was done in a tertiary medical college hospital, from September 2012 to August 2013. One hundred singleton pregnancies complicated by hypertension peculiar to pregnancy were enrolled. Both CU and CP ratios were estimated. The perinatal outcomes were studied.Results. Both cerebrouterine and cerebroplacental ratios had a better negative predictive value in predicting adverse perinatal outcome. However, both CU and CP ratios when applied together were able to predict adverse outcomes better than individual ratios. The sensitivity, specificity, positive predictive value, and the negative predictive values for an adverse neonatal outcome with CU ratio were 61.3%, 70.3%, 56%, and 78.9%, respectively, compared to 42%, 57.5%, 62%, and 76% as with CP ratio.Conclusion.Cerebrouterine ratio and cerebroplacental ratio were complementary to each other in predicting the adverse perinatal outcomes. Individually, both ratios were reassuring for favorable perinatal outcome with high negative predictive value.

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.

scholarly journals Significance of obstetric Doppler studies in prediction of perinatal outcome in pregnancy induced hypertension

2017 ◽  
Vol 6 (6) ◽  
pp. 2354 ◽  
Author(s):  
Pradip R. Gaikwad ◽  
Manisha R. Gandhewar ◽  
Nity Rose ◽  
Vidyadhar Suryakar
Keyword(s):  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Uterine Artery ◽  
Pregnancy Induced Hypertension ◽  
Doppler Studies ◽  
Uterine Artery Doppler ◽  
Adverse Perinatal Outcome ◽  
Induced Hypertension

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel color Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler studies in PIH and to analyse its role in predicting perinatal outcome.Methods: This was a prospective study of 106 singleton pregnancies in the third trimester with PIH. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study specificity and diagnostic accuracy of all Doppler ultrasound parameters was high in predicting adverse perinatal outcome. Cerebroplacental ratio showed highest specificity (98.55%), PPV (94.44%) and diagnostic accuracy (80.19%) in predicting adverse perinatal outcome and it is better than MCA PI and UA PI alone. Uterine artery Doppler evaluation also gives additional information in predicting adverse perinatal outcome.Conclusions: Amongst various Doppler parameters cerebroplacental index (MCA/UA PI) is best predictor of 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 Role of uterine artery doppler at 18-22 weeks in the prediction of pre-eclampsia: a prospective study

2020 ◽  
Vol 9 (10) ◽  
pp. 4130
Author(s):  
Lakshmi Manjeera M. ◽  
Patricia Malini Pereira
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Resistance Index ◽  
Early Screening ◽  
Predictive Values ◽  
Uterine Artery Doppler ◽  
Doppler Study

Background: Pre-eclampsia is the most common pregnancy complication associated with serious maternal and fetal morbidity. Uterine artery Doppler reflects the impaired trophoblastic invasion of the uterine spiral arteries, which is involved in the aetiology of preeclampsia. Thus, uterine artery Doppler was proposed as a screening test for pre-eclampsia.Methods: A prospective cohort study of 100 singleton pregnancies was conducted in a tertiary centre and the study population were subjected to uterine artery Doppler study at 18-22 weeks gestation. Uterine artery Doppler indices of pulsatility index (PI), resistance index (RI) and persistence of diastolic notch was obtained and the outcome of pre-eclampsia was studied.Results: Out of 100 women, 14 women developed pre-eclampsia in which the resistance index showed a sensitivity of 21.4%, specificity of 91.8%, positive predictive value of 30% and negative predictive value of 87.7% and pulsatility index showed sensitivity of 35.7%, specificity of 90.6%, positive predictive value of 38.4% and negative predictive value of 89.6%. Diastolic notch had a sensitivity of 35.7%, specificity of 98.8%, positive predictive value of 83.3% and a negative predictive value of 90.4%.Conclusions: The high negative predictive values, indicated that women with normal Doppler velocimetry were unlikely to develop preeclampsia. Uterine artery Doppler, being non-invasive can be included during routine sonography to identify patients at risk of developing pre-eclampsia. Early, screening for pre-eclampsia will help in individualized antenatal surveillance and initiation of prophylactic therapy, early to reduce the adverse maternal and foetal complications of preeclampsia.

Predictive value of middle cerebral artery to uterine artery pulsatility index ratio in preeclampsia

2010 ◽  
Vol 284 (2) ◽  
pp. 307-311 ◽  
Author(s):  
Ahmet Eser ◽  
Ebru Zulfıkaroglu ◽  
Suleyman Eserdag ◽  
Sevtap Kılıc ◽  
Nurı Danısman
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Predictive Value ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Index Ratio

scholarly journals The predictive value of sFlt-1/PIGF ratio in high risk patients for the development of preeclampsia

2019 ◽  
Vol 8 (9) ◽  
pp. 3705
Author(s):  
Isha Sunil ◽  
Mitali Sharma
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Maternal Morbidity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Maternal Morbidity And Mortality ◽  
Risk Patients ◽  
The Mean ◽  
Plgf Ratio

Background: Hypertensive disorders of pregnancy constitute a major cause of maternal morbidity and mortality. Pre-eclampsia/eclampsia ranks second only to haemorrhage as a specific, direct cause of maternal mortality. A number of markers have been under study for the early detection of this disease. The study aims to evaluate the predictive value of sFlt-1/PlGF ratio for preeclampsia.Methods: This study was conducted in the Department of Gynaecology and Obstetrics of ASCOMS hospital, Jammu for a period of 6 months from Jan 2019 to June 2019. 50 antenatal patients attending the outpatient department with risk factors for developing preeclampsia were enrolled in the study. Their sFlT-1/PIGF ratio was determined at gestational age of 20 weeks to 37 weeks and its predictive value was evaluated.Results: In the present study, 8 patients developed preeclampsia subsequently. The mean sFlt-1/PIGF ratio values were significantly higher in the patients who developed preeclampsia (73.5) than who did not develop the disease (26.07). The positive predictive value at 1 week was 41.66% and negative predictive value was 100%. At 4 weeks, positive predictive value was 66.66% and negative predictive value was 100%.Conclusions: The present study suggests sFlt-1/PIGF ratio values are useful marker was a predictor of preeclampsia and values >38 were associated with preeclampsia. It is more useful in ruling out preeclampsia than ruling in the disease.

scholarly journals Third trimester Doppler ultrasound as prediction of obstetric outcome in high-risk pregnancy, Gujarat, India

2017 ◽  
Vol 6 (8) ◽  
pp. 3518
Author(s):  
Runoo Ghosh ◽  
Hina Oza ◽  
Shikha Meel
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Lower Limit ◽  
Perinatal Outcome ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Third Trimester ◽  
Adverse Perinatal Outcome ◽  
Diastolic Velocity

Background: Doppler ultrasound has emerged as beneficial tool in the assessment of the fetal and placental circulation and in the prediction of adverse pregnancy outcome. Umbilical artery Doppler has proved helpful to supervise the growth restricted fetuses and compromised vasculature as in hypertensive disorders high risk pregnancies. Objective of present study was to investigate the association between third-trimester uterine artery Doppler assessment and adverse obstetric outcome.Methods: This prospective study was done among 110 high risk pregnancies. Vessel like uterine artery, umbilical artery, middle cerebral artery and ductus venosus were studied in present study. Indices calculated: Peak systolic velocity, End diastolic velocity, Mean velocity, Systolic/diastolic ratio, Pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA), Ductus venosus S/A ratio.Results: bilateral notch was present statistically significant (p<0.05) in 18.1% and absent in 28.2% among cases of adverse perinatal outcome. UA S/D ratio was >3 in 22.7% and <3 in 11.8% among cases of adverse perinatal outcome and findings were statistically significant (p<0.05). End diastolic velocity was reduced in statistically significant (p<0.05) in 9.1% and normal in 20.1% among cases of adverse perinatal outcome. MCA PI was <lower limit statistically significant (p<0.05) in 24.5% and >lower limit in 18.2% among cases of adverse perinatal outcome. MCA PI/UA PI ratio was <1 statistically significant (p<0.05) in 25.5% and absent in 17.3% among cases of adverse perinatal outcome.Conclusions: Increase in UA PI and decrease in MCA PI are early marker for detection of fetal compromise. Ratio of indices between MCA PI and UA PI reflects brain sparing effect as well as placental insufficiency and these are more specific in detection of IUGR than individual artery indices.

scholarly journals ROLE OF DOPPLER INDICES IN THE PREDICTION OF ADVERSE PERINATAL OUTCOME IN PREECLAMPSIA

2021 ◽  
Vol 71 (4) ◽  
pp. 1209-1213
Author(s):  
Shakra Tabasam ◽  
Zaib Malik ◽  
Asifa Siraj ◽  
Sadaf Afroz
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Military Hospital ◽  
Reference Standard ◽  
Adverse Perinatal Outcome ◽  
Doppler Study ◽  
Sensitivity Specificity

Objective: To determine diagnostic accuracy of systolic/diastolic ratio and cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2017. Methodology: A total of 191 patients with preeclampsia were included. Doppler ultrasound (including doppler wave forms obtained from free floating portion of umbilical artery and doppler waveform from middle cerebral artery at the level of circle of Willis) examination was done after gestational age 30 weeks and Doppler study repeated at 2-4 weeks interval depending on severity of preeclampsia and abnormalities of waveform. Cases were followed and results of last Doppler examination within 10 days of delivery were considered and perinatal outcome noted. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of systolic/diastolic ratio in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 82.35%, 86.52%, 87.50%, 81.05% and 84.29% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 78.67%, 92.24%, 86.76%, 86.99% and 86.91% respectively. Conclusion: The diagnostic accuracy of systolic/diastolic ratio, cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia is quite high.

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