Role of cerebroplacental index and uterine artery Doppler in the diagnosis and prognosis of fetal growth restriction
DOI:
https://doi.org/10.62452/9dv1p266Keywords:
Fetal growth restriction, cerebroplacental ratio, uterine artery doppler, perinatal outcomes, prenatal diagnosis, fetal prognosisAbstract
This study aimed to evaluate the accuracy of the cerebroplacental ratio (CPR) and uterine artery Doppler in predicting adverse perinatal outcomes in cases of fetal growth restriction (FGR). A literature review of studies published since 2014 was conducted, using databases such as PubMed and EMBASE, focusing on cohort and cross-sectional studies that analyzed the relationship between these Doppler parameters and perinatal outcomes. The results showed that CPR had moderate to high accuracy for predicting perinatal death, with pooled sensitivity and specificity of 93% and 76%, respectively. However, its accuracy was low for other adverse outcomes, such as emergency cesarean section or neonatal acidosis. Uterine artery Doppler alone detected less than 40% of FGR cases, but its combination with other parameters improved predictive accuracy. It is concluded that CPR and uterine artery Doppler are useful tools in the diagnosis and prognosis of FGR, although further studies are needed to assess their impact on fetal neurodevelopment.
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Conde-Agudelo, A., Villar, J., Kennedy, S. H., & Papageorghiou, A. T. (2018). Predictive accuracy of cerebroplacental ratio for adverse perinatal and neurodevelopmental outcomes in suspected fetal growth restriction: systematic review and meta-analysis. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 52(4), 430–441. https://doi.org/10.1002/uog.19117
Figueras, F., Caradeux, J., Crispi, F., Eixarch, E., Peguero, A., & Gratacos, E. (2018). Diagnosis and surveillance of late-onset fetal growth restriction. American journal of obstetrics and gynecology, 218(2S), S790–S802.e1. https://doi.org/10.1016/j.ajog.2017.12.003
Flatley, C., Greer, R. M., & Kumar, S. (2017). Magnitude of change in fetal cerebroplacental ratio in third trimester and risk of adverse pregnancy outcome. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 50(4), 514–519. https://doi.org/10.1002/uog.17371
Gordijn, S. J., Beune, I. M., Thilaganathan, B., Papageorghiou, A., Baschat, A. A., Baker, P. N., Silver, R. M., Wynia, K., & Ganzevoort, W. (2016). Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 48(3), 333–339. https://doi.org/10.1002/uog.15884
MacDonald, T. M., Hui, L., Robinson, A. J., Dane, K. M., Middleton, A. L., Tong, S., & Walker, S. P. (2019). Cerebral-placental-uterine ratio as novel predictor of late fetal growth restriction: prospective cohort study. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 54(3), 367–375. https://doi.org/10.1002/uog.20150
Martins, J. G., Biggio, J. R., & Abuhamad, A. (2020). Society for maternal-fetal medicine consult series# 52: diagnosis and management of fetal growth restriction:(replaces clinical guideline number 3, April 2012). American journal of obstetrics and gynecology, 223(4), B2-B17. https://pubmed.ncbi.nlm.nih.gov/32407785/
McCowan, L. M., Figueras, F., & Anderson, N. H. (2018). Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy. American journal of obstetrics and gynecology, 218(2S), S855–S868. https://doi.org/10.1016/j.ajog.2017.12.004
Pedroso, M. A., Palmer, K. R., Hodges, R. J., Costa, F. D. S., & Rolnik, D. L. (2018). Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction. Doppler das artérias uterinas no rastreamento para pré-eclâmpsia e restrição do crescimento fetal. Revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 40(5), 287–293. https://doi.org/10.1055/s-0038-1660777
Rizzo, G., Mappa, I., Bitsadze, V., Słodki, M., Khizroeva, J., Makatsariya, A., & D'Antonio, F. (2020). Role of Doppler ultrasound at time of diagnosis of late-onset fetal growth restriction in predicting adverse perinatal outcome: prospective cohort study. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 55(6), 793–798. https://doi.org/10.1002/uog.20406
Springer, S., Worda, K., Franz, M., Karner, E., Krampl-Bettelheim, E., & Worda, C. (2023). Fetal Growth Restriction Is Associated with Pregnancy Associated Plasma Protein A and Uterine Artery Doppler in First Trimester. Journal of clinical medicine, 12(7), 2502. https://doi.org/10.3390/jcm12072502
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R., & Nicolaides, K. H. (2016). Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 47(3), 308–315. https://doi.org/10.1002/uog.14898
Vollgraff Heidweiller-Schreurs, C. A., De Boer, M. A., Heymans, M. W., Schoonmade, L. J., Bossuyt, P. M. M., Mol, B. W. J., De Groot, C. J. M., & Bax, C. J. (2018). Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 51(3), 313–322. https://doi.org/10.1002/uog.18809
Yu, H., Yuan, M., Wang, L., Li, X., & Jiang, M. (2021). Correlation between Parturients' Uterine Artery Blood Flow Spectra in the First and Second Trimesters of Pregnancy and Fetal Growth Restriction. Journal of healthcare engineering, 2021, 2129201. https://doi.org/10.1155/2021/2129201
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