Title: The Reliability of the Cerebroplacental Ratio in the Prediction of Perinatal Outcome in IUGR Babies
Authors: Dr Thanooja S, Dr Rajeena Babu R, Dr Nirmala C
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.178
Abstract
Introduction: IUGR complicates up to 10%of pregnancies. Cerebroplacental ratio (CPR-MCA PI/ Umbilical artery PI) is emerging as a good tool for the prediction of perinatal adverse outcomes in IUGR babies. We attempted to study the sensitivity, specificity, positive and negative predictive value of CPR in predicting adverse perinatal outcome.
Materials and Methods: It is a prospective study done in the Dept of O&G at Govt Medical College, Thiruvananthapuram. 65 cases of clinically detected ultrasound confirmed cases of IUGR in third trimester were the subjects. Serial Doppler measurements of the umbilical artery, middle cerebral artery at 1-3 weeks interval were recorded till a decision for termination of pregnancy was taken. Last measurement values were taken for statistical analysis. Based on these measurements patients were classified into 3 groups.
Group 1-IUGR with normal Doppler velocimetry in all 3 vessels
Group 2-IUGR with abnormal UA PI alone, CPR <1
Group 3-IUGR abnormal MCA and UA PI, CPR>1.
Results: Pregnancy outcome measures included gestational age at delivery, mode of delivery, birth weight, Apgar scores, presence of meconium staining of amniotic fluid and need for NICU admissions more than 24 hours. Data was compared among 3 groups. All outcome measures showed a statistically significant difference among groups (p<.05) except mode of delivery (p>.05). CPR had a sensitivity of 54.5%, specificity of 87.5%, +predictive value of 81.8 % and negative predictive value of 65% in predicting adverse perinatal outcome.
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