Utility of Doppler parameters at 36–42 weeks’ gestation in the prediction of adverse perinatal outcomes in appropriate-for-gestational-age fetuses

Migda, Michał; Gieryn, Katarzyna; Migda, Bartosz

doi:10.15557/jou.2018.0004

Cited by 5 publications

(3 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding ROC analysis, CPRMOM was considered a good negative indicator than a positive one in both cases of CS due to fetal distress at cut-off value 0.97 with sensitivity of 72.7% and specificity 91.4% with AUC 0.778 and P value = 0.005, and in cases of NICU admission at cut-off value 0.84 with sensitivity of 75.0% and specificity 92.3% with AUC 0.827 and P value < 0.001. While CPR was considered a poor indicator for cases of initial Pathological CTG, lower APGAR score and umbilical PH [table 6, figure 3,4,5,6,7]. Our result coincides with Prior et al [27] who reported that abnormal CPR was a better predictor for emergency CS than abnormal UA or MCA.…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Effat

Nabil

2021

International Journal of Medical Arts

View full text Add to dashboard Cite

Objective of theStudy: To test the efficacy of the cerebroplacental ratio [CPR] in the prediction of early labor fetal distress and adverse neonatal outcomes in full-term [FT] low risk pregnancy. Patients and Methods: One hundred fifty pregnant women met the inclusion and exclusion criteria were subjected for the estimation of umbilical artery [UA] and middle cerebral artery [MCA] pulsatility indices [PI]]. CPR is calculated by dividing MCAPI by UAPI. All of these measures have been converted to multiple medians [MOMs]. The findings of CPR MOM were Correlated with the following; traces of cardiotocography; cesarean section [CS] for fetal distress; 5 min APGAR scoring; cord PH; and NICU admission. The ROC curve was used to test CPRMOM's predictive performance of adverse perinatal outcomes.Results: Out of 150 patients, 18 [12%] showed abnormal CPR MOM<1. All adverse perinatal outcomes were significantly higher among participants with reduced CPR MOM <1 compared to those with normal one, P value =0.000. There was negative significant correlation between CPRMOM and both of emergency CS, [r=-0.293, P<0.001] and NICU admission [r=-0.302, P<0.001. ROC curve showed that CPRMoM is good negative predictor, in both CS due to fetal distress, and NICU admission at cut off values,≤0.97 and ≤0.84 with sensitivity, 72.7 % and 75.0 %, specificity, 91.4 % and 92.3 % with AUCs, 0.778 and 0.827, P = 0.005, and < 0.001 respectively. Conclusion:Reduced CPRMOM < 1 considers a good predictor for both of CS due to fetal distress and NICU admission; however normal CPR doesn't perfectly rule them out. Reduced CPR MOM is a poor predictor for each of initial non reassuring CTG, APGAR score at 5 min and lower umbilical PH. Nevertheless, normal CPRMOM considers as good predictor for normal fetuses.

show abstract

Section: Discussionsupporting

confidence: 88%

“…So, the available screening policy depends on history of disease and intrapartum events do not define high risk cases that prone to intrapartum hypoxia. Therefore, perinatal care should determine the fetuses with hypoxia rather than small fetuses [6] .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Effat

Nabil

2021

International Journal of Medical Arts

View full text Add to dashboard Cite

show abstract

“…In recent years, an increasing number of studies investigate the association of CPR with adverse outcome in low-risk and/or AGA pregnancies [56][57][58][59][60][61][62][63][64][65][66][67][68][69]. Initially, it may appear unconventional to associate CPR with adverse outcome in apparently healthy pregnancies.…”

Section: Association Of Cpr With Adverse Outcomes In Aga Fetusesmentioning

confidence: 99%

Clinical significance of cerebroplacental ratio

Kalafat

Khalil

2018

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Purpose of review Two-thirds of the pregnancies complicated by stillbirth demonstrate growth restriction. Identification of the foetus at risk of growth restriction is essential to reduce the risk of stillbirth. The aim of this review is to critically appraise the current evidence regarding clinical utility of cerebroplacental ratio (CPR) in antenatal surveillance. Recent findings The CPR has emerged as an assessment tool for foetuses at increased risk of growth disorders. CPR is a better predictor of adverse events compared with middle-cerebral artery or umbilical artery Doppler alone. The predictive value of CPR for adverse perinatal outcomes is better for suspected small-for-gestational age foetuses compared with appropriate-for-gestational age (AGA) foetuses. CPR could be useful for the risk stratification of small-for-gestational age foetuses to determine the timing of delivery and also to calculate the risk of intrapartum compromise or prolonged admission to the neonatal care unit. Although there are many proposed cut-offs for an abnormal CPR value, evidence is currently lacking to suggest the use of one cut-off over another. CPR appears to be associated with increased risk of intrapartum foetal compromise, abnormal growth velocity, and lower birthweight in AGA foetuses as well. Moreover, birthweight differences are better explained with CPR compared to other factors such as ethnicity. However, the role of CPR in predicting adverse perinatal outcomes such as acidosis or low Apgar scores in AGA foetuses is yet to be determined. Summary CPR appears to be a useful surrogate of suboptimal foetal growth and intrauterine hypoxia and it is associated with a variety of perinatal adverse events.

show abstract

Natural History of Secundum ASD in Preterm and Term Neonates: A Comparative Study

Heidari,

Kumaran,

Pagano

et al. 2024

Pediatr Cardiol

View full text Add to dashboard Cite

Background: Atrial septal defects(ASDs) are common in neonates. Although past studies suggest ASDs >3mm in term neonates(TN) are less likely to close, there is paucity of data regarding the natural history in preterm neonates(PN), information that would inform surveillance. We sought to compare spontaneous closure rates and need for intervention for ASDs in TN/near term (>36 weeks) versus PN (<36 weeks).Methods: We included all TN and PN who underwent echocardiography at <1 month between 2010-2018 in our institution with an ASD >3mm, without major congenital heart disease, and with repeat echocardiogram(s). Spontaneous resolution was de ned as size diminution to £3mm or closure.Results: We included 156 TN (mean gestational age at birth 38.6±1.4 weeks) and 156 PN (29.6±3.7 weeks) with a mean age at follow-up of 16±19 and 15±21 months, respectively (p=0.76). Based on largest color Doppler diameter, in TNs, ASD resolution occurred in 95% of small (3-5mm), 87% of moderate (5.1-8mm), and 60% of large (>8mm) defects; whereas, in PNs, resolution occurred in 79% of small, 76% of moderate, and 33% of large ASDs. There was a signi cant association between size and ASD resolution in TNs (p=0.003), but not PNs (p=0.17). Overall, ASD resolution rate was higher in TNs (89%) versus PNs (78%) (p=0.009), and fewer TNs (1%) compared to PNs (7%) required ASD intervention (p=0.02).Conclusion: Most ASDs identi ed in TN and PN spontaneously resolve. PN, however, demonstrate lower ASD resolution and higher intervention rates within all size groups. These data should inform follow-up of affected neonates.

show abstract

Utility of Doppler parameters at 36–42 weeks’ gestation in the prediction of adverse perinatal outcomes in appropriate-for-gestational-age fetuses

Cited by 5 publications

References 24 publications

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Clinical significance of cerebroplacental ratio

Natural History of Secundum ASD in Preterm and Term Neonates: A Comparative Study

Contact Info

Product

Resources

About