Clinical significance of cerebroplacental ratio
- PMID: 30299319
- DOI: 10.1097/GCO.0000000000000490
Clinical significance of cerebroplacental ratio
Abstract
Purpose of review: Two-thirds of the pregnancies complicated by stillbirth demonstrate growth restriction. Identification of the foetus at risk of growth restriction is essential to reduce the risk of stillbirth. The aim of this review is to critically appraise the current evidence regarding clinical utility of cerebroplacental ratio (CPR) in antenatal surveillance.
Recent findings: The CPR has emerged as an assessment tool for foetuses at increased risk of growth disorders. CPR is a better predictor of adverse events compared with middle-cerebral artery or umbilical artery Doppler alone. The predictive value of CPR for adverse perinatal outcomes is better for suspected small-for-gestational age foetuses compared with appropriate-for-gestational age (AGA) foetuses. CPR could be useful for the risk stratification of small-for-gestational age foetuses to determine the timing of delivery and also to calculate the risk of intrapartum compromise or prolonged admission to the neonatal care unit. Although there are many proposed cut-offs for an abnormal CPR value, evidence is currently lacking to suggest the use of one cut-off over another. CPR appears to be associated with increased risk of intrapartum foetal compromise, abnormal growth velocity, and lower birthweight in AGA foetuses as well. Moreover, birthweight differences are better explained with CPR compared to other factors such as ethnicity. However, the role of CPR in predicting adverse perinatal outcomes such as acidosis or low Apgar scores in AGA foetuses is yet to be determined.
Summary: CPR appears to be a useful surrogate of suboptimal foetal growth and intrauterine hypoxia and it is associated with a variety of perinatal adverse events.
Similar articles
-
Predictive accuracy of cerebroplacental ratio for adverse perinatal and neurodevelopmental outcomes in suspected fetal growth restriction: systematic review and meta-analysis.Ultrasound Obstet Gynecol. 2018 Oct;52(4):430-441. doi: 10.1002/uog.19117. Epub 2018 Sep 5. Ultrasound Obstet Gynecol. 2018. PMID: 29920817
-
Magnitude of change in fetal cerebroplacental ratio in third trimester and risk of adverse pregnancy outcome.Ultrasound Obstet Gynecol. 2017 Oct;50(4):514-519. doi: 10.1002/uog.17371. Epub 2017 Sep 5. Ultrasound Obstet Gynecol. 2017. PMID: 27873370
-
Routine assessment of cerebroplacental ratio at 35-37 weeks' gestation in the prediction of adverse perinatal outcome.Am J Obstet Gynecol. 2019 Jul;221(1):65.e1-65.e18. doi: 10.1016/j.ajog.2019.03.002. Epub 2019 Mar 13. Am J Obstet Gynecol. 2019. PMID: 30878322
-
The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses.Am J Obstet Gynecol. 2015 Jul;213(1):5-15. doi: 10.1016/j.ajog.2015.05.024. Am J Obstet Gynecol. 2015. PMID: 26113227 Review.
-
Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term.Best Pract Res Clin Obstet Gynaecol. 2017 Jan;38:38-47. doi: 10.1016/j.bpobgyn.2016.09.003. Epub 2016 Sep 23. Best Pract Res Clin Obstet Gynaecol. 2017. PMID: 27720309 Review.
Cited by
-
Efficiency of the Cerebroplacental Ratio in Identifying High-Risk Late-Term Pregnancies.Medicina (Kaunas). 2023 Sep 15;59(9):1670. doi: 10.3390/medicina59091670. Medicina (Kaunas). 2023. PMID: 37763790 Free PMC article.
-
Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses.Front Physiol. 2022 Aug 19;13:959750. doi: 10.3389/fphys.2022.959750. eCollection 2022. Front Physiol. 2022. PMID: 36060697 Free PMC article. Review.
-
Cerebroplacental Ratio Versus Nonstress Test in Predicting Adverse Perinatal Outcomes in Hypertensive Disorders of Pregnancy: A Prospective Observational Study.Cureus. 2022 Jun 30;14(6):e26462. doi: 10.7759/cureus.26462. eCollection 2022 Jun. Cureus. 2022. PMID: 35923670 Free PMC article.
-
Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations.Front Pediatr. 2022 Jan 11;9:748345. doi: 10.3389/fped.2021.748345. eCollection 2021. Front Pediatr. 2022. PMID: 35087771 Free PMC article. Review.
-
Fetal Growth Restriction - Diagnostic Work-up, Management and Delivery.Geburtshilfe Frauenheilkd. 2020 Oct;80(10):1016-1025. doi: 10.1055/a-1232-1418. Epub 2020 Sep 25. Geburtshilfe Frauenheilkd. 2020. PMID: 33012833 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Research Materials
Miscellaneous