Prediction of adverse perinatal outcome by Doppler velocimetry of middle cerebral and umbilical artery

2020 ◽  
Vol 13 (3) ◽  
pp. 162-167
Author(s):  
Parag Vijaysingh Patil ◽  
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Doppler Velocimetry ◽  
Adverse Perinatal Outcome

scholarly journals Serum uric acid as marker of severity of pre-eclampsia

2017 ◽  
Vol 6 (11) ◽  
pp. 4915 ◽  
Author(s):  
Shirish Toshniwal ◽  
Aakriti R. Lamba
Keyword(s):  
Multivariate Regression ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Neonatal Resuscitation ◽  
Resistive Index ◽  
Adverse Outcomes ◽  
Foetal Distress ◽  
High Relative Risk ◽  
Adverse Perinatal Outcome ◽  
Foetal Growth

Background: In pre-eclampsia, there is increased uteroplacental resistance and reduced foetal perfusion due to inadequate invasion of spiral arterioles by trophoblast cells. This causes impaired foetal growth and foetal hypoxia. To assess the usefulness of foetal Doppler in predicting adverse perinatal outcome in preeclampsia.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA - Pulsatility Index (PI) and UA - Resistive Index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI <2SD was taken as abnormal.Results: There were 107 women in the study. Major adverse outcomes 11. Umbilical artery - S/D ratio >2SD (RR 4.46, 95%, CI 1.40-14.17) and RI >2SD (RR 3.36, 95%, CI 1.03-10.61) and MCA RI <2SD (RR 4.46, 95% CI 1.4-14.17) had a high relative risk to predict adverse major perinatal outcome. 39 babies were admitted in neonatal nursery and no parameters could predict them. Though UA - PI >2SD predicted acute foetal distress in labour (RR 2.33, 95% CI 1.21-4.47), there was no association on multivariate regression analysis.Conclusions: This study showed UA-S/D ratio and UA-RI >2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute foetal distress in labour or neonatal nursery admission could not be predicted.

scholarly journals Correlation of efficacy of cerebro placental ratio with adverse perinatal outcome in clinically suspected IUGR pregnancies

2018 ◽  
Vol 7 (5) ◽  
pp. 1808
Author(s):  
Geeta Singh ◽  
Neerja Gupta ◽  
Sangeeta Singhal ◽  
Pramod Kishor Sharma
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Pulsatility Index ◽  
Umbilical Artery ◽  
Doppler Velocity ◽  
Wave Form ◽  
Adverse Perinatal Outcome ◽  
Diastolic Flow ◽  
Ultrasound Evaluation

Background: IUGR is a most common and complex problem in modern obstetrics. Most commonly use methods to assess fetal condition are BPP and NST which are not sensitive for predicting better perinatal outcome.  Present study was an effort to evaluate the role of ratio of pulsatility index (PI) of middle cerebral artery and umbilical artery which is called cerebro placental ratio as the most sensitive, specific and accurate predictor of adverse perinatal outcome in clinically suspected IUGR Pregnancies.Methods: 50 clinically suspected IUGR Pregnancies attending antenatal clinics Muzaffarnagar Medical College and Hospital, Muzaffarnagar were subjected to Doppler ultrasound evaluation Doppler velocity wave form of umbilical artery and fetal middle cerebral artery were obtained. Pulsatility index ratio of MCA and umbilical artery (cerebro placental ratio) was evaluated in each case. Abnormal ratio is defined as CPR<1.08 considered as cut of value. Ratio was coo related clinically with perinatal outcome.Results: Out of 50 antenatal cases, 63% neonates had birth weight <2.5 kg. There were 6 IUD’S and 44 live births, 9 neonates were admitted to NICU, 7 neonates had 5 min. APGAR score <7 and 13 neonates were born by emergency CS. Of the 6 IUDS, 4 cases had reversal of blood flow umbilical artery and 2 cases had absent diastolic flow. In all cases of reversal Diastolic flow, IUD occurred within 7 days of diagnosis. Conclusions: CPR is the most sensitive, specific and accurate parameter in prediction of adverse perinatal outcome and thus can help in decreasing perinatal mortality.

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