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- W2896488124 abstract "Doppler assessments combining information from the uterine, placental, and/or fetal vessels may improve detection of placental insufficiency near term. We prospectively examined Doppler measurements at 36 weeks to determine which parameters (alone or in combination) best identified fetuses subsequently born SGA or with evidence of uteroplacental insufficiency. 347 nulliparous women had blood flow resistance (pulsatility index; PI) in the uterine arteries (UtA), umbilical artery (UA), and several fetal vessels (including the middle cerebral artery (MCA)) measured at 36 weeks using Doppler ultrasound. We compared measurements from individual vessels, and from combinations such as the cerebroplacental ratio (CPR=MCA PI/UA PI) in their prediction of birthweights <10th, <5th and <3rd centile, as decreasing centiles represent increasing severity of FGR. We also compared their associations with other parameters that reflect placental insufficiency: fetal growth velocity across pregnancy, and neonatal body fat measures. The UtA PI and CPR were the best Doppler parameters for predicting birthweight <10th centile. We therefore generated a new parameter - the cerebral-placental-uterine ratio (CPUR=CPR/UtA PI). The CPUR was better at detecting FGR compared to UtA PI and CPR. At ∼90% specificity, low CPUR (<0.71MoM) had sensitivities of 50% for birthweight <10th centile, 68% for <5th centile, and 89% for <3rd centile, compared to respective sensitivities of 26%, 37% and 44% for low CPR, and 34%, 47% and 67% for high UtA PI. Low CPUR predicted birthweight <10th centile with an odds ratio (OR) of 9.1, <5th centile with OR of 17.3, and <3rd centile with OR of 57 (p<0.0001 for all). The CPUR correlated most strongly with fetal growth velocity and neonatal body fat. This new Doppler combination, the CPUR, has a strong association with placental insufficiency. The CPUR is a promising marker of placental insufficiency, and may detect FGR better than previously reported Doppler parameters." @default.
- W2896488124 created "2018-10-26" @default.
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- W2896488124 date "2018-10-01" @default.
- W2896488124 modified "2023-10-18" @default.
- W2896488124 title "OC24.04: The association between the cerebral-placental-uterine ratio and fetal growth restriction: a prospective cohort study" @default.
- W2896488124 doi "https://doi.org/10.1002/uog.19369" @default.
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