Cerebro-placental ratio (
CPR) with a threshold value of less than 1.08 has been suggested to closely reflect acute changes in pO2
, indicating fetal hypoxia in IUGR.
Objective: The objective of the study was to evaluate the sensitivity and specificity of CPR in clinically diagnosed cases of IUGR and to predict adverse perinatal outcome in cases of abnormal CPR.
Setting: The study was conducted at a tertiary care hospital.
Materials and Methods: One hundred and twenty consecutive clinically suspected cases of singleton IUGR pregnancies at 34-40 weeks of gestation where enrolled in the study. In all antenatal mothers Doppler velocimetry was carried out and CPR calculated. The mode of delivery and any adverse perinatal outcome; asphyxia, hypoglycemia, perinatal death or stay in neonatal intensive care unit (NICU) was recorded. The data was compiled and analyzed using Statistical Package for Social Sciences, version 16.0.
Results: Among these 120 women, three babies born with congenital malformations were excluded from the study. In 117 study women, abnormal CPR (<1.08) was found in 65 cases with statistically significant correlation for prediction of cesarean section delivery (p<0.001) and low birth weight (p<0.001). A strong association was also noted with CPR (<1.08) and APGAR score less than 7 at 5 minutes (68%), admission to the NICU (86%) and perinatal mortality (66%). The positive predictive value for CPR was 92.31%.
Conclusion: CPR offers an important surrogate marker to assess the fetal well-being in utero and can help to reduce the risk of prenatal mortality by timely intervention at delivery.