Prognostic accuracy of cerebroplacental ratio for adverse perinatal outcomes in pregnancies complicated with severe pre-eclampsia; a prospective cohort study

Alanwar, Ahmed; Nour, Ayman Abou El; Mandooh, Mohamed El; Abdelazim, Ibrahim A.; Abbas, Luma; Abbas, Ahmed M.; Abdallah, Ameer; Nossair, Wael S.; Shikanova, Svetlana

doi:10.1016/j.preghy.2018.08.446

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…Hypertensive issues is a common clinical scenario facing obstetricians all over the globe hypertension developing during gestation or preexisting before pregnancy could seriously affect the fetal growth pattern by influencing the pattern of placental vascular development and could affect the placental process of aging at cellular and various vascular fetal indices are affected as a result. 11 Previous research groups of investigators investigated the fetal vascular indices as a noninvasive method to predict the fetal wellbeing and its impact on fetal and neonatal weight. Umilical artery one of the crucial vascular indices reflects the main artery vascular flow that is affected by angiogenic factors released during pregnancy .Middle cerebral artery PI was observed from previous research studies to detect and reflect the brain sparing effect that could be an adaptive protective mechanism in casee of reduced placental blood flow from the umbilical vascular system.…”

Section: Discussionmentioning

confidence: 99%

Cerebroplacental ratio in gestational hypertension and its impact on neonatal weight

Alalfy¹,

Okasha²,

Abdalfatah³

2020

OGIJ

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Background: Pregnancy a physiological process that involves changes in vascular system responsiveness that affects the placental development in direct and indirect methods by hormonal and other signals that are critical in normal blood flow rates within the fetal system. Predicting fetal outcome using sonographic indices is considered a noninvasive valuable protocol to manage cases with hypertensive disorders with pregnancy. Fetal weight is one of the critical issues faced by obstetricians and perinatologists Aim of the study: to determine the value of cerebro placental ratio in predictability of neonatal weight in cases of gestational hypertension. Patients and Methods: A prospective observational cross sectional study that included 100 pregnant women, 50 ladies had gestational hypertension and 50 women as normal control group attending the antenatal care clinic of Algezeera hospital. Ultrasonographic assessment was carried out with evaluation of routine fetal biometry in addition to Middle cerebral artery (MCA), Umbilical artery (UA) Doppler indices. Results: UA PI, MCA PI, CPR, Fetal weight and birth weight were statistically significantly higher among the control research group in comparison to the hypertension with pregnancy research group (p values<0.001). Conclusion: Cerebroplacental ratio is a promising ultrasonographic marker for fetal and neonatal weight that could aid in prediction of neonatal wellbeing and clinical prognosis of hypertensive cases in pregnancy.

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Section: Discussionmentioning

confidence: 99%

Cerebroplacental ratio in gestational hypertension and its impact on neonatal weight

Alalfy¹,

Okasha²,

Abdalfatah³

2020

OGIJ

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“…Nine studies reported the prognostic value of CPR 11 13 15 19 20 23 26 33 34. CPR showed promising predictive value for adverse perinatal outcomes in unselected pregnancies in the third trimester.…”

Section: Resultsmentioning

confidence: 99%

Prognostic accuracy of antenatal Doppler ultrasound for adverse perinatal outcomes in low-income and middle-income countries: a systematic review

et al. 2021

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ObjectivesThis systematic review examined available literature on the prognostic accuracy of Doppler ultrasound for adverse perinatal outcomes in low/middle-income countries (LMIC).DesignWe searched PubMed, Embase, Cochrane Library and Scopus from inception to April 2020.SettingObservational or interventional studies from LMICs.ParticipantsSingleton pregnancies of any risk profile.InterventionsUmbilical artery (UA), middle cerebral artery (MCA), cerebroplacental ratio (CPR), uterine artery (UtA), fetal descending aorta (FDA), ductus venosus, umbilical vein and inferior vena cava.Primary and secondary outcome measuresPerinatal death, stillbirth, neonatal death, expedited delivery for fetal distress, meconium-stained amniotic fluid, low birth weight, fetal growth restriction, admission to neonatal intensive care unit, neonatal acidosis, Apgar scores, preterm birth, fetal anaemia, respiratory distress syndrome, length of hospital stay, birth asphyxia and composite adverse perinatal outcomes (CAPO).ResultsWe identified 2825 records, and 30 (including 4977 women) from Africa (40.0%, n=12), Asia (56.7%, n=17) and South America (3.3%, n=01) were included. Many individual studies reported associations and promising predictive values of UA Doppler for various adverse perinatal outcomes mostly in high-risk pregnancies, and moderate to high predictive values of MCA, CPR and UtA Dopplers for CAPO. A few studies suggested that the MCA and FDA may be potent predictors of fetal anaemia. No randomised clinical trial (RCT) was found. Most studies were of suboptimal quality, poorly powered and characterised by wide variations in outcome classifications, the timing for the Doppler tests and study populations.ConclusionLocal evidence to guide how antenatal Doppler ultrasound should be used in LMIC is lacking. Well-designed studies, preferably RCTs, are required. Standardisation of practice and classification of perinatal outcomes across countries, following the international standards, is imperative.PROSPERO registration numberCRD42019128546

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“…(88.1%) assessing the adverse outcomes in severely preeclamptic women, but the detected sensitivity in our study is approximately one-fourth of their report that was accounted for 50%. [ 24 ] This significant difference may have occurred due to the design of the studies as we have assessed hypertension thoroughly, but they have conducted their study on cases with severe preeclampsia only.…”

Section: Discussionmentioning

confidence: 99%

“…represented lower specificity and higher sensitivity for CPR in the detection of academia due to delivery in preeclamptic women, but the accuracy of their study was somewhat similar to ours. [ 24 ]…”

Section: Discussionmentioning

confidence: 99%

Predictive value of middle cerebral artery to umbilical artery pulsatility index ratio for neonatal outcomes in hypertensive disorders of pregnancy

2022

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Prognostic accuracy of cerebroplacental ratio for adverse perinatal outcomes in pregnancies complicated with severe pre-eclampsia; a prospective cohort study

Cited by 11 publications

References 19 publications

Cerebroplacental ratio in gestational hypertension and its impact on neonatal weight

Cerebroplacental ratio in gestational hypertension and its impact on neonatal weight

Prognostic accuracy of antenatal Doppler ultrasound for adverse perinatal outcomes in low-income and middle-income countries: a systematic review

Predictive value of middle cerebral artery to umbilical artery pulsatility index ratio for neonatal outcomes in hypertensive disorders of pregnancy

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