Cerebroplacental Doppler Ratio and Cerebrouterine Doppler Ratio in Predicting Neonatal Outcome in Preeclamptic Pregnant Women

Abstract

Background: Umbilical artery and middle cerebral artery Doppler ultrasound clearly depict the information about placental resistance and the changes in the fetal hemodynamics in response to it. The aim of this work was to assess the role of cerebroplacental ratio and cerebrouterine ratio in prediction of neonatal outcome in preeclamptic women. Methods: This prospective observational study was carried out on 110 pre eclamptic women. Patients were divided into two groups: Preeclampsia with severe features (n=58) and preeclampsia (n=52). All patients were subjected to laboratory testing (complete blood count (CBC), coagulation profile, liver and kidney function tests, 24 hours urine sample collection) and ultrasonographic scanning trans - abdominal sonographic examinations. Results: The cut off value of CP ratio was 1.09 with sensitivity 84%, specificity 89%, PPV (positive predictive value) 94%, NPV (negative predictive value) 73% and accuracy 85% while the study cut off value of CU ratio was 1.3 with sensitivity 97%, specificity 93%, PPV 95%, NPV 95% and accuracy 95%. UTA, UMBA, MCA, CP and CU were significantly higher in Preeclampsia with severe features than Preeclampsia (P value <0.05). Conclusions: Most of unfavourable neonatal outcome associated with abnormal cerebroplacental and cerebrouterine ratio so cerebroplacental and cerebrouterine ratio were complementary to each other in predicting the adverse neonatal outcomes.