The Value or Cerebro-Placental Ratio, Umbilical and Middle Cerebral Arteries’ Pulsatility Indices in Predicting Perinatal Adverse Outcomes Related to Preeclampsia at 34-40 Weeks of Gestation

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology.Cairo University Hospitals

2 department of obstetrics an gynecology .Cairo University Hospitals.

3 Department of Obstetrics and Genecology, Faculty of Medicine, Cairo University, Egypt

4 Department of Obstetrics and Genecology, Faculty of Medicine, Cairo University, Egy

Abstract

Introduction: Proper evaluation of preeclampsia is one of the mainstays of the obstetric practice worldwide. It is important given it has possible devastating consequences, it is one of the leading causes of maternal and perinatal morbidity and mortality.
Methods: This was a prospective case-control study conducted in the emergency department of the maternity department of Kasr-Al Ainy University teaching hospital involving 62 pregnant women diagnosed with preeclampsia and 62 healthy pregnant women all between 34-40 weeks of gestation; they were all submitted to Doppler ultrasound examination of the fetal umbilical and middle cerebral arteries (RI, PI and S/D). Cerebro-placental ratio was also calculated. The link to adverse maternal and perinatal outcomes was examined. The level of statistical significance was set at p ≤ 0.05.
Results: Among the women diagnosed with preeclampsia, 93.5% delivered via C-section compared to 53.2% in the control group. UA and MCA (PI and S/D) and cerebro-placental ratio were higher in the patients’ group compared to the control group. All Doppler parameters were associated with higher incidence of adverse perinatal outcomes including IUGR, low birth weight, metabolic acidosis, and low APGAR score and NICU admission. Abnormal MCA (RI, PI and S/D), UA (PI and S/D) and CPR Doppler indices had 100% specificity in predicting IUGR, low birth weight and NICU admission with 100% PPV.
Conclusion: Assessing Doppler parameters including MCA, UA and CPR is an integral tool to guide the evaluation and management of preeclampsia to avoid complications and improve maternal and perinatal outcomes

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