Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Document Type : Original Article


1 Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Egypt

2 Department of Pediatrics and Neonatology, Faculty of Medicine for Girls, Al-Azhar University, Egypt


Objective of the Study: To test the efficacy of the cerebroplacental ratio [CPR] in the prediction of early labor fetal distress and adverse neonatal outcomes in full-term [FT] low risk pregnancy.
Patients and Methods:One hundred fifty pregnant women met the inclusion and exclusion criteria were subjected for the estimation of umbilical artery [UA] and middle cerebral artery [MCA] pulsatility indices [PI]]. CPR is calculated by dividing MCAPI by UAPI. All of these measures have been converted to multiple medians [MOMs]. The findings of CPR MOM were Correlated with the following; traces of cardiotocography; cesarean section [CS] for fetal distress; 5 min APGAR scoring; cord PH; and NICU admission. The ROC curve was used to test CPRMOM's predictive performance of adverse perinatal outcomes.
Results:Out of 150 patients, 18 [12%] showed abnormal CPR MOM There was negative significant correlation between CPRMOM and both of emergency CS, [r=-0.293, p <0.001] and NICU admission [r=-0.302, p <0.001. ROC curve showed that CPRMoM is good negative predictor, in both CS due to fetal distress, and NICU admission at cut off values,≤0.97 and ≤0.84 with sensitivity, 72.7 % and 75.0 %, specificity, 91.4 % and 92.3 % with AUCs, 0.778 and 0.827, P = 0.005, and < 0.001 respectively.
Conclusion: Reduced CPRMOM < 1 considers a good predictor for both of CS due to fetal distress and NICU admission; however normal CPR doesn’t rule them out. Reduced CPR MOM is a poor predictor for each of initial non reassuring CTG, APGAR score at 5 min and lower umbilical PH. Nevertheless, normal CPRMOM considers as good predictor for normal fetuses.


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