Volume 22 Issue 4
Fetal Cerebroplacental Ratio in Early Labor as a Predictor of Adverse Perinatal Outcomes in Low-Risk Term Pregnancies
Kirti Singh, Neema Acharya, Ketav Samir Joshi, Nidhi Singh
Abstract
Background and Aim: The cerebroplacental ratio (CPR) was evaluated in this study to detect the early changes in fetal circulation that can remain undiagnosed in low-risk pregnancies. The aim of this study was to evaluate the role of CPR in early labor in predicting adverse perinatal outcomes in low-risk term pregnancies and establishing its importance in improving maternal and child health care.
Materials and Methods: This was a prospective observational study done over a period of 2 years, during early labor in low-risk term pregnancies. Totally, 994 pregnant women were included in the study. The women were subjected to Doppler ultrasonography at the time of early labor, and the fetal CPR was calculated. Adverse perinatal outcomes were correlated with normal and abnormal CPRs.
Results: The occurrence of adverse perinatal outcomes was significantly more in the fetuses who had an abnormal CPR (< 1) than in those who had a normal CPR (> 1). The sensitivity, specificity, and negative predictive value of fetal CPR in detecting and predicting adverse perinatal outcomes were 95.65%, 80.97%, and 99.6%, respectively. However, the positive predictive value of abnormal CPR was 27.27%, which is low.
Conclusion: Fetal CPR can be used as a predictive tool to identify at-risk fetuses in low-risk term pregnancies with underlying subtle placental dysfunction. The fetuses can be triaged in early labor itself and managed with intensive intrapartum fetal monitoring.
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