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Cerebroplacental ratio

Florian M Stumpfe, Sven Kehl, Jutta Pretscher, Friederike Baier, Christian M Bayer, Eva Schwenke, Michael O Schneider, Andreas Mayr, Ralf L Schild, Matthias Schmid, Matthias W Beckmann, Florian Faschingbauer
OBJECTIVE: To evaluate the association of short-term variation (STV) and Doppler parameters with adverse perinatal outcome in low-risk fetuses at term. METHODS: This was a retrospective study of 1008 appropriate-for-gestational age (AGA) term fetuses. Doppler measurements [umbilical artery (UA), middle cerebral artery (MCA), and cerebroplacental ratio (CPR)] and computerized CTG (cCTG) with STV analysis were performed prior to active labor (≤ 4 cm cervical dilatation) within 72 h of delivery...
December 3, 2018: Archives of Gynecology and Obstetrics
Oliver Graupner, Javier U Ortiz, Bernhard Haller, Annette Wacker-Gussmann, Renate Oberhoffer, Bettina Kuschel, Joy Weyrich, Christoph Lees, Silvia M Lobmaier
PURPOSE: Fetal Doppler changes are well characterized in early-onset small-for-gestational-age (SGA) and fetal growth restriction (FGR) but less well characterized where the condition is late-onset. The aim of the study was to evaluate the role of computerized CTG (cCTG)-based short-term variation (STV) in late-onset SGA and FGR as an additional monitoring modality and to establish STV reference ranges in late third trimester healthy pregnancies. METHODS: Of 86 late-onset SGA fetuses diagnosed after 32 weeks, 66 were diagnosed with FGR...
November 16, 2018: Archives of Gynecology and Obstetrics
Magdalena Fiolna, Vira Kostiv, Christos Anthoulakis, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To investigate the performance of screening for adverse perinatal outcome by the cerebroplacental ratio (CPR) measured within 24 hours of induction of labor. METHODS: This was a prospective observational study in 1,902 singleton pregnancies undergoing induction of labor at ≥ 37 weeks' gestation. Doppler ultrasound was used to measure the pulsatility index (PI) in the umbilical artery (UA) and fetal middle cerebral artery (MCA) before induction of labor...
November 13, 2018: Ultrasound in Obstetrics & Gynecology
Anca Ciobanu, Alan Wright, Argyro Syngelaki, David Wright, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To develop reference ranges with gestational age for the pulsatility index in the umbilical artery (UA-PI) and fetal middle cerebral artery (MCA-PI and the cerebroplacental ratio (MCA-PI / UA-PI) and examine the maternal characteristics and medical history that affect these measurements. PATIENTS AND METHODS: This was a cross-sectional study of 72,417 pregnancies undergoing routine ultrasound examination at 20+0 to 22+6 weeks' gestation (n=3,712), or at 31+0 to 33+6 weeks (n=29,035) or at 35+0 to 36+6 weeks (n=37,282) or at 41+0 to 41+6 weeks (n=2,388)...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
Chelsea Ho, Christopher J Flatley, Sailesh Kumar
OBJECTIVE: Some studies have suggested that the fetal cerebroplacental ratio (CPR) is an independent predictor of intrapartum fetal compromise and admission to the neonatal intensive care unit (NICU) at term particularly in small for gestational age (SGA) compared to appropriate for gestational age (AGA) infants. The aim of this study was to evaluate the association between the CPR and emergency caesarean for intrapartum fetal compromise (CS IFC) and NICU admission at term after adjusting for estimated fetal weight (EFW) and other confounding factors...
October 29, 2018: Journal of Maternal-fetal & Neonatal Medicine
Teresa M MacDonald, Lisa Hui, Alice J Robinson, Kirsten M Dane, Anna L Middleton, Stephen Tong, Susan P Walker
OBJECTIVES: Fetal growth restriction (FGR) is a major risk factor for stillbirth and most commonly arises from uteroplacental insufficiency. Despite clinical examination and third trimester fetal biometry, cases of FGR often remain undetected antenatally. Placental insufficiency is known to be associated with altered blood flow resistance in maternal, placental, and fetal vessels. We evaluated the performance of individual, and combined Doppler blood flow resistance measurements for the prediction of term FGR...
October 18, 2018: Ultrasound in Obstetrics & Gynecology
Jingyu Li, Bin Wang, Ailu Cai, Qian Yuan, Hao Ding, Dan Zhao
PURPOSE: This study aimed to determine whether the stiffness of the arterial walls of women with preeclampsia (PE) differs from that of healthy controls and to evaluate its association with fetal and uterine artery Doppler variables and perinatal outcomes in PE. METHODS: We enrolled 30 women with PE and 30 normotensive pregnant women. Carotid artery stiffness and Doppler variables of the uterine, umbilical, and fetal middle cerebral arteries and the ductus venosus were measured in both groups...
October 14, 2018: Journal of Clinical Ultrasound: JCU
Erkan Kalafat, Asma Khalil
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...
December 2018: Current Opinion in Obstetrics & Gynecology
Jessica M Turner, Christopher Flatley, Sailesh Kumar
BACKGROUND: A low fetal cerebroplacental ratio (CPR) and nulliparity have independently been shown to be associated with adverse obstetric and perinatal outcomes. OBJECTIVES: To assess the effect of parity on the CPR and investigate the utility of a CPR threshold of <10th centile for predicting adverse outcomes. We hypothesised that nulliparous women would have a lower CPR than multiparous women, impacting the diagnostic performance of the <10th centile threshold...
November 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
D Oros, S Ruiz-Martinez, E Staines-Urias, A Conde-Agudelo, J Villar, E Fabre, A T Papageorghiou
OBJECTIVES: To assess studies reporting reference ranges for Doppler indices of umbilical artery (UA), middle cerebral artery (MCA) and cerebroplacental ratio (CPR), using a set of predefined methodological quality criteria for study design, statistical analysis and reporting methods. METHODS: A systematic review of observational studies whose primary aim was to create reference ranges for Doppler indices of UA, MCA, and CPR in fetuses from singleton gestations was performed in MEDLINE, EMBASE, CINAHL, and Web of Science (all from inception to December 31, 2016), and references of retrieved articles...
August 20, 2018: Ultrasound in Obstetrics & Gynecology
Cristina Paules, Ana Paula Dantas, Jezid Miranda, Francesca Crovetto, Elisenda Eixarch, Victor Rodriguez-Sureda, Carmen Dominguez, Giulia Casu, Carlota Rovira, Alfons Nadal, Fatima Crispi, Eduard Gratacos
OBJECTIVE: The aim of this study was to perform a comprehensive assessment of the placental aging process through senescence and apoptotic markers in late-onset small fetuses classified as SGA or FGR. STUDY DESIGN: A prospective nested case-control study in singleton pregnancies delivering at term including 21 normally grown fetuses and 36 small fetuses classified into SGA (if birthweight was between the 3rd and 9th centile and normal fetoplacental Doppler; n=18) and FGR (if birthweight <3rd centile and/or abnormal cerebroplacental ratio or uterine artery Doppler; n=18)...
August 19, 2018: Ultrasound in Obstetrics & Gynecology
Nathalie J M Bravo-Valenzuela, Paulo Zielinsky, Jesús Zurita-Peralta, Luiz Henrique Nicoloso, Antonio Piccoli, Luiza Ferreira Van der Sand, Natássia Miranda Sulis, Camila Carvalho Ritter
INTRODUCTION: In intrauterine growth restriction (IUGR), increased uteroplacental vascular impedance contributes to preferential flow to left ventricle (LV), with consequent alteration of its compliance and increased left atrial (LA) pressure. Pulmonary vein pulsatility index (PVPI) reflects the increased impedance to LA filling and could be used as a cardiac monitoring parameter in IUGR. MATERIAL AND METHODS: A total of 27 IUGR fetuses (group 1), 28 fetuses with appropriate growth for gestational age from hypertensive mothers (group 2), and 28 controls (group 3) were studied...
August 17, 2018: Fetal Diagnosis and Therapy
Helen Sherrell, Vicky Clifton, Sailesh Kumar
INTRODUCTION: Intrapartum complications are a major contributor to adverse perinatal outcomes, including stillbirth, hypoxic-ischaemic brain injury and subsequent longer term disability. In many cases, hypoxia develops as a gradual process due to the inability of the fetus to tolerate the stress of parturition suggesting reduced fetoplacental reserve before labour commences. The fetal cerebroplacental ratio (CPR) is an independent predictor of intrapartum fetal compromise, poor acid base status at birth and of neonatal unit admission at term...
August 13, 2018: BMJ Open
Yao-Lung Chang, An-Shine Chao, Hsiu-Huei Peng, Shuenn-Dyh Chang, Kuan-Ju Chen, Po-Jen Cheng, Tzu-Hao Wang
BACKGROUND: We previously reported that fetal plasma erythropoietin (EPO) concentrations are significantly increased in growth-restricted fetuses with abnormal umbilical artery (UA) Doppler. During hypoxia in an ovine model, the primary site of fetal EPO synthesis was switched from the kidneys to the placenta. Therefore, we designed this study to evaluate human placental EPO gene expression and the correlation to fetal serum EPO concentration in growth-restricted fetuses in a monochorionic (MC) twin model...
August 8, 2018: BMC Pregnancy and Childbirth
S Kumar, F Figueras, W Ganzevoort, J Turner, L McCowan
No abstract text is available yet for this article.
October 2018: Ultrasound in Obstetrics & Gynecology
Ebru Alici Davutoglu, Aysegul Ozel, Funda Oztunc, Riza Madazli
OBJECTIVE: To compare the fetal modified myocardial performance index (Mod-MPI) in appropriately grown, early (EO) and late onset (LO) fetal growth restricted (FGR) fetuses and to assess its prognostic significance for adverse perinatal outcome. STUDY DESIGN: In a prospective case-control study, Mod-MPI was performed in 22 and 51 fetuses with EO and LO-FGR fetuses, respectively. Mod-MPI values of FGR fetuses were compared against gestation-matched controls (34 for EO-, and 32 for LO-FGR, respectively)...
July 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
Reem S Abu-Rustum, M Fouad Ziade, Ibrahim Ghosn, Nabil Helou
OBJECTIVE:  The aim of this study is to assess the feasibility of visualizing the middle cerebral artery (MCA), establishing the normogram for MCA pulsatility index (PI) and peak systolic velocity (PSV), and calculating cerebroplacental ratio (CPR) at 12 to 14 weeks. STUDY DESIGN:  Prospective cross-sectional study on 186 gravidas presenting for nuchal translucency (NT) assessment. Maternal body mass index (BMI), fetal crown-rump length (CRL), biparietal diameter (BPD), and NT were obtained...
July 6, 2018: American Journal of Perinatology
A Conde-Agudelo, J Villar, S H Kennedy, A T Papageorghiou
OBJECTIVE: The cerebroplacental ratio (CPR) has been proposed for the routine surveillance of pregnancies with suspected fetal growth restriction (FGR), but the predictive performance of this test is unclear. The aim of this study was to determine the accuracy of CPR for predicting adverse perinatal and neurodevelopmental outcomes in suspected FGR. METHODS: PubMed, EMBASE, CINAHL and Lilacs were searched from inception to 31 July 2017 for cohort or cross-sectional studies reporting on the accuracy of CPR for predicting adverse perinatal and/or neurodevelopmental outcomes in singleton pregnancies with FGR suspected antenatally based on sonographic parameters...
October 2018: Ultrasound in Obstetrics & Gynecology
Natthicha Chainarong, Chusana Petpichetchian
OBJECTIVES: The cerebroplacental ratio (CPR) Doppler has been proposed as an instrument for predicting adverse perinatal outcomes particularly during antepartum period. Abnormal CPR is associated with non-reassuring fetal status requiring operative delivery, low Apgar score and neonatal complications. The aim of this study was to assess the role of CPR Doppler in the labor triage suite, so as to identify fetuses at risk for non-reassuring status as well as other adverse perinatal outcomes...
September 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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