‘’TO EMPHASIZE ON THE IMPORTANCE OF ALTERED CEREBROPLACENTAL RATIO IN PREDICTING THE ADVERSE PERINATAL OUTCOME IN PATIENTS WITH ABNORMAL CEREBROPLACENTAL RATIO AND TIMELY INTERVENTION IN THESE FETUS TO PREVENT ADVERSE PERINATAL OUTCOME’’.
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Abstract
Introduction- Every newborn has the right to be born undamaged mentally and physically. The fulfillment of this goal plays a pivotal role in maternal-fetal medicine, whose sole objective is that every pregnancy should culminate into a healthy baby and a healthy mother. A high-risk pregnancy carries a greater risk to the mother or her fetus than an uncomplicated pregnancy. Pregnancy places additional physical and emotional stress on a woman’s body. Health problems that occur before a woman becomes pregnant or during pregnancy may also increase the likelihood for a high-risk pregnancy. Doppler is a noninvasive method for evaluation of fetoplacental circulation without any disturbance to human pregnancy. It gives valuable information about hemodynamic situation of the fetus and is an efficient diagnostic test of fetal jeopardy that helps in management of high-risk pregnancy. Doppler ultrasound technology evaluates umbilical artery (and other fetal arteries) waveforms to assess fetal well-being in the third trimester of pregnancy.
Aims and objectives- ‘‘To emphasize on the importance of altered cerebroplacental ratio in predicting the adverse perinatal outcome in patients with abnormal cerebroplacental ratio and timely intervention in these fetus to prevent adverse perinatal outcome.
’’ in patients with abnormal cerebroplacental ratio and timely intervention in these fetuses to prevent adverse perinatal outcome.
Material and methods- This study, Prospective observational study, was conducted in the Department of Obstetrics & Gynecology at tertiary care center at central India population periods of 2 Year, from January 2018 to January 2020. Patients those were attended OPD & got admitted as IPD, at 30-36 weeks of gestation comprised the study population. Only those women who fulfilled the inclusion criteria and were willing to participate in the study voluntarily were included in the study after taking an informed consent.
Results - In our study, 58% and 42% patients in control group were primigravida and multigravida respectively which was comparable to patients in Case group 56% and 44% respectively. Doppler flow velocity analysis can be valuable in antenatal assessment of SGA, FGR and even in AGA for prediction of late onset growth restriction and perinatal adverse outcome. By noninvasive hemodynamic monitoring of umbilical arteries (Feto-placental circulation) and middle cerebral arteries (fetal-circulation) has been a great help to improve perinatal outcome in pregnancy with comorbidities.
For the prediction of adverse perinatal outcome in women with high-risk pregnancies, the best doppler index according to our study was cerebroplacental ratio (MCA/UA PI ratio). In cases with abnormal doppler, timely interventions lead to improved perinatal outcome. Hence, repeated doppler study in these pregnancies can help to reduce perinatal morbidity and mortality in high-risk cases. Conclusions- This study also suggested that CP ratio has the value for identifying those fetuses at risk for adverse perinatal outcome even their weights was greater than the 10th centile but are at risk for adverse outcome or late onset FGR because of an abnormal or lower CP ratio than 50th percentile value for age specific cutoff value.
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Dr. Richa Sharma
MBBS, DGO DNB, OBGY, Senior resident, SRVS medical college, Shivpuri
Dr. Ayushi Shrivastava
MBBS, DNB, OBGY, Senior resident, SRVS medical college, Shivpuri
Dr. Rupali Singh
MS obstetrics and Gynaecology, Senior Resident, MGM medical college and MTH hospital, Indore
Pin 452001
Dr. Neelam Patel
Ex. Sr. Department of Obs. & gynae specialist, RKDF medical College Bhopal (M.P.)