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Role of cerebroplacental ratio for fetal assessment in prolonged pregnancy
Author(s) -
D'Antonio F.,
Patel D.,
Chandrasekharan N.,
Thilaganathan B.,
Bhide A.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.12357
Subject(s) - medicine , umbilical artery , middle cerebral artery , gestation , gestational age , obstetrics , fetus , pregnancy , umbilical cord , population , small for gestational age , gynecology , ischemia , genetics , environmental health , anatomy , biology
Objective The aim of this study was to assess the role of the cerebroplacental ratio ( CPR ), i.e. the ratio between the middle cerebral artery and umbilical artery pulsatility indices, in detecting fetal compromise in prolonged pregnancy. Methods Women attending a dedicated postdates clinic at 41 weeks' gestation were recruited for the study and CPR was calculated at 41+3 weeks. Induction of labor was offered at 42 weeks to those women still undelivered. Unfavorable outcome was defined as cord arterial pH < 7.15 with a base deficit of > 11 mM /L or operative delivery for abnormal intrapartum fetal electrocardiogram ST ‐segment analysis. The 5 th centiles of the CPR , obtained from published reference ranges (0.90) and from our population (0.98), were used as lower cut‐off values. Results Three hundred and twenty women who reached a gestational age of over 41 weeks were eligible for inclusion in the study. The median gestational age at delivery was 294 (range, 289–300) days. Unfavorable outcome was observed in 58/320 pregnancies. There was no significant difference in the proportion of unfavorable outcomes between the two groups defined using either CPR cut‐off value (both P > 0.05). Conclusion CPR is not predictive of unfavorable outcome in women with pregnancies lasting more than 41 weeks. Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.