Efficacy of Cerebroplacental Doppler Ratio in Predicting Adverse Fetal Outcomes in Cases of Fetal Growth Restriction Multicenter Study.

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2025-05-12 DOI:10.1002/jcu.24076

Mohamed S Hemeda, Heba Youssef Sayed, Wael M Hamed, Medhat Kamel, Mohamed Saleh, Sileem Ahmed Sileem, Ahmed Abd Elhamid, Ibrahim Arafa Reyad Arafa, Emad Ahmed Abdelmooty

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引用次数: 0

Abstract

Introduction: Fetal growth restriction (FGR) is a significant cause of perinatal morbidity and mortality. Differentiating FGR from small-for-gestational-age fetuses is critical for risk assessment. This study investigates the cerebroplacental ratio (CPR) as a noninvasive predictor of adverse fetal outcomes, particularly neonatal intensive care unit (NICU) admissions, intrauterine fetal death (IUFD), and birth weight variability.

Methods: This prospective, multicentre study included 60 pregnant women (gestational age 28-34 weeks) divided into normal and abnormal CPR groups. Doppler ultrasonography assessed umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices. Statistical analysis included receiver operating characteristic (ROC) curves for CPR, UA, and MCA indices to predict adverse outcomes.

Results: Abnormal CPR correlated with increased NICU admissions (46.7%), IUFD (10%), and lower birth weight (mean: 2138 g). Elevated UA PI and reduced MCA PI were observed in the abnormal CPR group. Sensitivity and specificity analyses identified CPR (cutoff: 1.1) as a modestly accurate predictor of adverse outcomes.

Discussion: CPR effectively stratifies risk in high-risk pregnancies but requires further validation. Abnormal Doppler findings highlight placental insufficiency and compromised cerebral perfusion. These findings could refine FGR management strategies.

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多中心研究中脑胎盘多普勒比值预测胎儿生长受限不良结局的有效性。

胎儿生长受限（FGR）是围产期发病和死亡的重要原因。区分FGR和小胎龄胎儿是风险评估的关键。本研究调查了脑胎盘比（CPR）作为不良胎儿结局的无创预测因子，特别是新生儿重症监护病房（NICU）入院、宫内胎儿死亡（IUFD）和出生体重变异性。方法：本前瞻性多中心研究纳入60例孕妇（胎龄28-34周），分为正常CPR组和异常CPR组。多普勒超声评估脐动脉（UA）和大脑中动脉（MCA）脉搏指数。统计分析包括受试者工作特征（ROC）曲线的CPR、UA和MCA指数来预测不良结局。结果：心肺复苏术异常与新生儿重症监护病房入院人数增加（46.7%）、IUFD（10%）和低出生体重（平均：2138 g）相关。异常CPR组UA PI升高，MCA PI降低。敏感性和特异性分析确定CPR（截止值：1.1）是一个中等准确的不良结局预测因子。讨论：心肺复苏术对高危妊娠的风险分层有效，但需要进一步验证。异常多普勒显示胎盘功能不全和脑灌注受损。这些发现可以完善FGR管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.