Abstract: Background and Aim: In hypertensive disorders of pregnancy, defective placentation leads to an increase in vascular resistance in the uteroplacental circulation, which can lead to decreased uteroplacental perfusion. Cerebro-placental ratio (Doppler ultrasound) incorporates data of both umbilical artery (Placental status) and the middle cerebral artery (Fetal response) and is a better index than using either of them alone for predicting adverse fetal and neonatal outcome and help us in improving fetal and neonatal outcomes.
Materials and Methods: A prospective observational study was done in a teaching hospital after taking ethical clearance from Institutional Review Committee. A total of 200 hypertensive pregnant women between 36-40 weeks of gestation underwent doppler ultrasound, and CPR ratio < 1 (done within one week of delivery) was considered abnormal.
Results: The study showed that the rate of adverse fetal and neonatal outcome was high in women with abnormal CPR than with normal CPR. In women with abnormal CPR increased rate of oligohydramnios (16.4% vs. 8.3%), fetal growth restriction (98.2% vs. 42.8%), rate of caesarean section delivery (90.9% vs. 46.9%), LSCS for fetal distress (63.82 vs. 46.51%), low birth weight (87.3% vs. 31.7%), Apgar score less than 7 at 5 minutes of birth (80.8% vs. 13.2%), need of resuscitation (100% vs. 41%), NICU admission (100% vs. 36.8%), early neonatal death (21.8% vs. 2.1%), late neonatal death (10.9% vs. 0.7%).
Conclusion: The cerebroplacental ratio in hypertension in pregnancy can provide useful information regarding fetal well-being and help us in improving fetal and neonatal outcomes.
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