Diagnostic accuracy of Doppler ultrasound in predicting perinatal outcome in pregnancies at term: A prospective longitudinal study

Abstract

Introduction: To explore the strength of association and the diagnostic accuracy of umbilical (UA), middle cerebral (MCA), uterine arteries pulsatility index (PI) and the cerebroplacental ratio in predicting an adverse outcome when applied to singleton pregnancies at term. Material and methods: Prospective study carried out in a dedicated research ultrasound clinic. Attended clinicians were blinded to Doppler findings. Inclusion criteria were consecutive singleton pregnancies between 36 +0 and 37 +6 weeks of gestation. The primary outcome was a composite score of adverse perinatal outcome. Logistic regression and ROC curve analyses were used to analyze the data. Results: In all, 600 consecutive singleton pregnancies from 36 weeks of gestation were included in the study. Mean MCA PI (1.1 ± 0.2 vs 1.5 ± 0.4, P < 0.001) and cerebroplacental ratio (1.4 ± 0.4 vs 1.9 ± 0.6, P < 0.001) were lower, whereas uterine arteries PI (0.8 ± 0.2 vs 0.7 ± 0.3, P = 0.001) was higher in pregnancies experiencing than in those not experiencing composite adverse outcome. Conversely, there was no difference in either UA PI (P = 0.399) or estimated fetal weight centile (P = 0.712) between the two groups, but AC centile was lower in fetuses experiencing composite adverse outcome (45.4 vs 53.2, P = 0.040). At logistic regression analysis, MCA

Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study

“…Conversely, a decrease in MCA PI has been shown in up to 20% of late FGR with a normal UA PI [1] and has been reported to be associated with poor short- and long-term outcomes, such as stillbirth, CD for fetal distress, and abnormal neurodevelopment at birth and at 2 years [23-26]. In 1987, the ratios between these 2 parameters (CPR and UCR) were described and henceforth have been claimed to be even more accurate in predicting perinatal morbidity and mortality, detecting subtle changes that could remain potentially inappreciable when exploring UA or MCA individually [27, 28]. The CPR has been more often evaluated than the UCR and incorporated in clinical guidelines, given its easier interpretation to clinicians due to its normal distribution.…”

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

“…In this cohort, the incidence of adverse perinatal outcome was calculated to be 19.4%, which was a little higher than the 17.9% by Fiolna et al (13), 9.5% by Antonio et al (14), and lower than 28.5% by Asta et al (15). We considered that the different inclusion criteria, cohort characteristics, races, and the de nitions of adverse perinatal outcome were the main explanations for the different results.…”

Diagnostic Accuracy of Doppler Ultrasound in Predicting Perinatal Outcome in Appropriate for Gestational Age Fetuses: A Prospective Study

“…We have recently reported that MCA and CPR are not predictive of adverse outcome in an unselected population of singleton pregnancies at term [8].…”

“…The study was approved by the local IRB (approval number: rich5j7v9). The present study shares part of its population with that of our recently published study exploring the diagnostic accuracy of fetal Doppler for predicting perinatal outcome once applied to an unselected population of singleton pregnancies close to or at term [8].…”