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https://www.readbyqxmd.com/read/28708272/prognostic-accuracy-of-cerebroplacental-ratio-and-middle-cerebral-artery-doppler-for-adverse-perinatal-outcomes-a-systematic-review-and-meta-analysis
#1
REVIEW
Charlotte A Schreurs, Marjon A de Boer, Martijn W Heymans, Linda J Schoonmade, Patrick M M Bossuyt, Ben Willem J Mol, Christianne J M de Groot, Caroline J Bax
OBJECTIVE: Ultrasonographic assessment of the cerebroplacental ratio (CPR) and middle cerebral artery (MCA) Doppler is widely used as an additional method to umbilical artery (UA) Doppler to identify fetuses at risk of adverse perinatal outcomes. However, reported estimates of its accuracy vary considerably. We conducted a systematic review with meta-analysis of studies on the prognostic accuracy of CPR and MCA Doppler, and compared this to UA Doppler. METHODS: We queried PubMed, EMBASE, the Cochrane Library, and ClinicalTrials...
July 14, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28708246/three-dimensional-power-doppler-evaluation-of-cerebral-vascular-blood-flow-a-novel-tool-in-the-assessment-of-fetal-growth-restriction
#2
Katherine R Goetzinger, Alison G Cahill, Linda Odibo, George A Macones, Anthony O Odibo
OBJECTIVES: To determine whether fetuses with fetal growth restriction (FGR) are more likely to have abnormal cerebral vascular flow patterns compared to fetuses who are appropriate for gestational age (AGA) when quantified by using 3-dimensional (3D) power Doppler ultrasound. METHODS: We conducted a prospective cohort study of singleton gestations presenting for growth ultrasound examination between 24 and 36 weeks' gestation. Patients with FGR (estimated fetal weight < 10th percentile) were enrolled and matched 1:1 for gestational age (±7 days) with AGA fetuses...
July 14, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28637734/pregnancy-specific-stress-fetoplacental-haemodynamics-and-neonatal-outcomes-in-women-with-small-for-gestational-age-pregnancies-a-secondary-analysis-of-the-multicentre-prospective-observational-trial-to-optimise-paediatric-health-in-intrauterine-growth-restriction
#3
Terri A Levine, Ruth E Grunau, Ricardo Segurado, Sean Daly, Michael P Geary, Mairead M Kennelly, Keelin O'Donoghue, Alyson Hunter, John J Morrison, Gerard Burke, Patrick Dicker, Elizabeth C Tully, Fergal D Malone, Fiona A Alderdice, Fionnuala M McAuliffe
OBJECTIVES: To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619771/revealed-versus-concealed-criteria-for-placental-insufficiency-in-an-unselected-obstetric-population-in-late-pregnancy-ratio37-randomised-controlled-trial-study-protocol
#4
Francesc Figueras, Eduard Gratacos, Marta Rial, Ilan Gull, Ladislav Krofta, Marek Lubusky, Rogelio Cruz-Martinez, Mónica Cruz-Lemini, Miguel Martinez-Rodriguez, Pamela Socias, Cristina Aleuanlli, Mauro C Parra Cordero
INTRODUCTION: Fetal growth restriction (FGR) affects 5%-10% of all pregnancies, contributing to 30%-50% of stillbirths. Unfortunately, growth restriction often is not detected antenatally. The last weeks of pregnancy are critical for preventing stillbirth among babies with FGR because there is a pronounced increase in stillbirths among growth-restricted fetuses after 37 weeks of pregnancy. Here we present a protocol (V.1, 23 May 2016) for the RATIO37 trial, which evaluates an integrated strategy for accurately selecting at-risk fetuses for delivery at term...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28594099/cerebroplacental-ratio-thresholds-measured-within-two-weeks-of-birth-and-the-risk-of-cesarean-section-for-intrapartum-fetal-compromise-and-adverse-neonatal-outcome
#5
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: Prediction of intrapartum fetal compromise in uncomplicated, term pregnancies is a global obstetric challenge. Currently, no widely accepted screening test for this condition exists, although the cerebroplacental ratio (CPR) shows promise. We aimed to prospectively evaluate the screening performance of the CPR 10(th) centile for detection of Cesarean section for intrapartum fetal compromise (IFC) and composite adverse neonatal outcome (ANO) in low-risk women from 36 weeks and to determine the best CPR threshold from three previously described in the literature...
June 8, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28556937/abnormal-fetal-findings-associated-with-a-global-sphericity-index-of-the-4-chamber-view-below-the-5th-centile
#6
Greggory R DeVore, Gary Satou, Mark Sklansky
OBJECTIVES: The purpose of this study was to evaluate the global sphericity index (GSI) of the 4-chamber view and correlate the results with abnormal ultrasound findings. METHODS: The epicardial end-diastolic basal-apical length (BAL) and transverse length (TL) of the 4-chamber view were measured to compute the GSI (BAL/TL) in 200 control fetuses between 20 and 40 weeks' gestation. Three hundred study fetuses were prospectively examined between 17 and 39 weeks' gestation...
May 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28546663/comparison-of-outcome-of-normal-and-high-risk-pregnancies-based-upon-cerebroplacental-ratio-assessed-by-doppler-studies
#7
Anita Kant, Namrata Seth, Deepti Rastogi
OBJECTIVES: To evaluate the cerebroplacental ratio which is the ratio of pulsatility index of fetal middle cerebral and umbilical arteries, in normal and high-risk pregnancies during 30-36 weeks of gestation. METHODS: In this study, we included 70 patients, who were scanned for Doppler parameters of Middle cerebral artery and Umbilical artery pulsatility index ratio of fetus, between 30 and 36 weeks, and then were followed till delivery. Thirty-five patients with normal pregnancy and 35 patients with high-risk pregnancy were included...
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28436166/perinatal-loss-at-term-the-role-of-uteroplacental-and-fetal-doppler-assessment
#8
Caitriona Monaghan, Julia Binder, Baskaran Thilaganathan, José Morales-Roselló, Asma Khalil
OBJECTIVE: To examine the association of uterine artery (UtA) Doppler indices and cerebroplacental ratio (CPR) on perinatal outcome at term. METHODS: This retrospective cohort study conducted in a single tertiary referral centre included all singleton pregnancies undergoing ultrasound assessment in the third trimester, which subsequently delivered at term. Fetal biometry and Dopplers including the umbilical artery (UA), middle cerebral artery (MCA) and uterine artery were recorded...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28294442/prediction-of-adverse-perinatal-outcome-by-cerebroplacental-ratio-adjusted-for-estimated-fetal-weight
#9
Angelo Sirico, Anke Diemert, Peter Glosemeyer, Kurt Hecher
OBJECTIVES: The aim of our study was to evaluate the relationship between the cerebroplacental ratio (CPR) and estimated fetal weight (EFW). Furthermore, we evaluated the role of CPR in the prediction of adverse perinatal outcome and whether CPR measurements adjusted for EFW improve its predictive value. METHODS: This is a retrospective cohort study including pregnancies, where Doppler investigations of umbilical artery (UA) and middle cerebral artery (MCA) were performed after 30 weeks...
March 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28216258/review-systematic-review-of-the-utility-of-the-fetal-cerebroplacental-ratio-measured-at-term-for-the-prediction-of-adverse-perinatal-outcome
#10
REVIEW
Liam Dunn, Helen Sherrell, Sailesh Kumar
AIM: This systematic review evaluates the utility of the fetal cerebroplacental ratio (CPR) when assessed at term (from 37 + 0 weeks gestation) as a predictor of adverse obstetric and perinatal outcomes. DATA SOURCES AND SEARCH STRATEGY: An electronic search of Pubmed and Embase using variations of 'cerebroplacental ratio' and 'cerebroumbilical ratio' was conducted by two independent reviewers. Full text studies written in English that reported on low CPR and its correlation with relevant obstetric and perinatal outcomes were included...
June 2017: Placenta
https://www.readbyqxmd.com/read/28103875/effects-of-plasmodium-falciparum-infection-on-umbilical-artery-resistance-and-intrafetal-blood-flow-distribution-a-doppler-ultrasound-study-from-papua-new-guinea
#11
Maria Ome-Kaius, Stephan Karl, Regina Alice Wangnapi, John Walpe Bolnga, Glen Mola, Jane Walker, Ivo Mueller, Holger Werner Unger, Stephen John Rogerson
BACKGROUND: Doppler velocimetry studies of umbilical artery (UA) and middle cerebral artery (MCA) flow help to determine the presence and severity of fetal growth restriction. Increased UA resistance and reduced MCA pulsatility may indicate increased placental resistance and intrafetal blood flow redistribution. Malaria causes low birth weight and fetal growth restriction, but few studies have assessed its effects on uteroplacental and fetoplacental blood flow. METHODS: Colour-pulsed Doppler ultrasound was used to assess UA and MCA flow in 396 Papua New Guinean singleton fetuses...
January 19, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28027669/the-vertebroplacental-ratio-as-an-alternative-to-the-cerebroplacental-ratio-in-the-evaluation-of-the-fetus-at-the-end-of-pregnancy
#12
José Morales-Roselló, Asma Khalil, Victoria Fornés-Ferrer, David Hervas-Marín, Nuria Peralta-Llorens, Juan Rubio-Moll, Alfredo Perales-Marín
OBJECTIVE: Low cerebroplacental ratio (CPR) near term has emerged as a marker of fetal adverse outcome. The aim of this study was to evaluate the predictive accuracy of an alternative ratio using the vertebral artery (VA) (vertebroplacental ratio or VPR) for acid-base status at birth. METHODS: This was a prospective cohort study of 1470 pregnancies undergoing an ultrasound assessment of the umbilical artery, middle cerebral artery and VA Doppler beyond 34 weeks' gestation within 14 days of delivery...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28004439/prediction-of-fetal-growth-restriction-using-estimated-fetal-weight-versus-a-combined-screening-model-at-32-36-weeks-of-gestation
#13
Jezid Miranda, Merida Rodriguez-Lopez, Stefania Triunfo, Mikko Sairanen, Heikki Kouru, Miguel Parra-Saavedra, Francesca Crovetto, Francesc Figueras, Fatima Crispi, Eduard Gratacos
OBJECTIVES: To compare the performance of a third trimester screening based on estimated fetal weight (EFW) versus a combined model composed by maternal baseline characteristics, mean arterial pressure (MAP), ultrasound and biochemical markers for the prediction of smallness for gestational age (SGA) and late-onset fetal growth restriction (FGR). METHODS: Nested case-control study within a prospective cohort of 1,590 singleton gestations referred for third-trimester evaluation (32-36 weeks of gestation)...
December 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27873370/the-magnitude-of-change-in-the-fetal-cerebroplacental-ratio-in-the-third-trimester-and-the-risk-of-adverse-pregnancy-outcome
#14
Christopher Flatley, Ristan M Greer, Sailesh Kumar
OBJECTIVE: The primary aim of this study was to evaluate if the magnitude of change in the cerebro-placental ratio (CPR) after 30 weeks gestation was better predictive of adverse pregnancy outcome compared to a single measurement at 35-37 weeks. A secondary aim was to evaluate whether the utility of CPR measured at 35-37 weeks was enhanced after adjusting for the gestational change. METHODS: This was a retrospective cohort study of women who had had at least two ultrasound scans between 30-37 weeks gestation with the final scan taking place at 35-37 weeks...
November 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27867608/changes-in-biometry-and-cerebroplacental-hemodynamics-in-fetuses-with-congenital-heart-diseases
#15
EDITORIAL
Alberto Borges Peixoto, Gabriele Tonni, Edward Araujo Júnior
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27794572/the-value-of-the-cerebroplacental-ratio-for-the-prediction-of-intrapartum-fetal-monitoring-in-low-risk-term-pregnancies
#16
Jing Liu, Guang Song, Ge Zhao, Tao Meng
AIM: The study aimed to investigate the use of fetal cerebroplacental ratio (CPR) to identify fetuses at high risk before labor due to the brain sparing phenomenon. MATERIALS AND METHODS: Four hundred and seventy-six singleton pregnancies were enrolled in this study. The CPR was recorded within 1 week of delivery and labor was managed according to local protocols and guidelines. Intrapartum and neonatal outcome details were recorded. RESULTS: The CPR values of fetuses subsequently presenting category III intrapartum electronic fetal monitoring (EFM) or category II EFM without improvement (category IIB EFM) or with progression to category III (category IIC EFM) were significantly lower...
October 29, 2016: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/27720309/role-of-uteroplacental-and-fetal-doppler-in-identifying-fetal-growth-restriction-at-term
#17
REVIEW
Asma Khalil, Basky Thilaganathan
Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) - a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. The cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term...
January 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27706856/performance-of-a-third-trimester-combined-screening-model-for-the-prediction-of-adverse-perinatal-outcome
#18
Jezid Miranda, Stefania Triunfo, Merida Rodriguez-Lopez, Mikko Sairanen, Heikki Kouru, Miguel Parra-Saavedra, Francesca Crovetto, Francesc Figueras, Fatima Crispi, Eduard Gratacos
OBJECTIVE: To explore the potential value of a third trimester combined screening for the prediction of adverse perinatal outcome (APO) in the general population and among small-for-gestational age (SGA) neonates. METHODS: Nested case-control study within a prospective cohort of 1,590 singleton gestations referred for third-trimester evaluation (32(0) -36(6) weeks of gestation). Maternal baseline characteristics, mean arterial blood pressure, fetoplacental ultrasound and circulating biochemical markers [placental growth factor (PlGF), lipocalin-2, unconjugated estriol and inhibin A] were assessed in all women who subsequently presented an APO (n = 148) and in a control group without perinatal complications (n = 902)...
October 5, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27549587/the-fetal-cerebroplacental-ratio-in-pregnancies-complicated-by-gestational-diabetes-mellitus
#19
Anthea Gibbons, Christopher Flatley, Sailesh Kumar
OBJECTIVE: This study aimed to assess the relationship between the cerebroplacental ratio (CPR) and intrapartum and perinatal outcomes in pregnancies complicated by gestational diabetes mellitus. METHODS: This was a retrospective cohort study of women diagnosed with gestational diabetes mellitus (GDM) birthing at the Mater Mothers' Hospital in Brisbane between 2007 and 2015. The CPR in 1089 non-anomalous singleton fetuses measured between 34 + 0 and 36 + 6 weeks gestation was compared between types of GDM treatment groups and correlated with intrapartum and perinatal outcomes...
August 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27533115/the-effect-of-intraumbilical-fetal-nutrition-via-a-subcutaneously-implanted-port-system-on-amino-acid-concentration-by-severe-iugr-human-fetuses
#20
RANDOMIZED CONTROLLED TRIAL
Michael Tchirikov, Zhaxybay Sh Zhumadilov, Gauri Bapayeva, Michael Bergner, Michael Entezami
OBJECTIVE: To determine if intrauterine intraumbilical supplementation with amino acids (AA) and glucose can improve neonatal outcome of severe growth restricted human fetuses (IUGR). METHODS: Prospective pilot study of intrauterine treatment of severe IUGR fetuses [n=14, 27 weeks of gestation (range 23-31)] with cerebroplacental ratio <1, with long-term intraumbilical AA and glucose supplementation (10% of feto-placental blood volume/day) using a perinatal port system alone (n=5) or combined with hyperbaric oxygenation (n=1, HBO) vs...
February 1, 2017: Journal of Perinatal Medicine
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