Correlation between Cerebroplacental ratio and umbilical artery Doppler with pregnancy outcome in postdates

Abstract

Background: Postdate pregnancy is a real problem in modern obstetrics. Its incidence has been reported to be between 4-14% with an average of 10.5%. Postdate pregnancy is associated with increased risk of perinatal morbidity and mortality. Assessment of fetal wellbeing is a corner stone in the management of prolonged pregnancy.Aim: To assess the usefulness of cerebroplacental ratio (CPR) compared with umbilical artery Doppler alone in prediction of the intrapartum fetal hypoxia and the adverse perinatal outcome in uncomplicated pregnancies (low risk pregnancy) beyond 40 weeks.  Patients and Methods: This study was carried out on 60 pregnant women with uncomplicated postdate pregnancies beyond 40 weeks gestation attending the antenatal clinics of Al-Zahraa University Hospital for antepartum assessment of CPR.  Results:CPR had a high predictive value in postdate pregnancy with sensitivity, specificity, PPV and NPV (85.7%, 73.9%, 50%, and 94.4%), respectively, in comparison to other parameters, with cut off value (0.94).Conclusion:CPR had the highest sensitivity and NPV in prediction of neonatal outcome. Cerebroplacental ratio less than 0.94 were the best predictor of adverse perinatal outcome and neonatal ICU admission.