The Value of the Cerebroplacental Ratio for the Prediction of Intrapartum Fetal Monitoring in Low-Risk Term Pregnancies

Gynecol Obstet Invest. 2017;82(5):475-480. doi: 10.1159/000452664. Epub 2016 Oct 29.

Abstract

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. On multivariate logistic regression, CPR was independently associated with the risk of categories III EFM, IIB EFM and IIC EFM. CPR was also a predictor of categories III EFM, IIB EFM and IIC EFM.

Conclusions: Fetal CPR could be used to identify fetuses at high risk before labor and to help guide intrapartum management decisions.

Keywords: Cerebroplacental ratio; Classification of 3-tiered intrapartum; Doppler; Fetal compromise; Intrapartum electronic fetal monitoring.

MeSH terms

  • Adult
  • Cerebral Palsy / prevention & control
  • Delivery, Obstetric / methods
  • Female
  • Fetal Hypoxia / diagnosis*
  • Fetal Monitoring / methods*
  • Heart Rate, Fetal
  • Humans
  • Labor, Obstetric
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / embryology*
  • Pregnancy
  • Pregnancy Outcome
  • Risk Factors
  • Ultrasonography, Prenatal
  • Umbilical Arteries / diagnostic imaging
  • Umbilical Arteries / embryology*