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Article Detail
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Prediction of Perinatal Outcomes in Full-Term Fetuses Appropriates for Gestational Age by Evaluation of Cerebroplacental Ratio (Cpr) Before the Active Phase of Labor
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| Author:
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HOMEIRA VAFAEI, NASRIN ASADI, RAZIYEH VANDA, MAHNAZ YADOLLAHI, HADI RAEISI SHAHRAKI
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| Abstract:
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Objective: Fetal hypoxia is one of the main reasons for the high mortality rate in pregnancy. Delivery is a hypoxic process, with contractions reducing blood flow to the arteries of the uterus, thereby reducing the amount of oxygen available to the placenta and fetus .evaluation of cerebroplacental ratio (CPR) before active phase of labor in prediction of perinatal outcomes in Iranian full-term fetuses appropriate for gestational age.
Methods: This was a prospective cohort study in 137 women with singleton term pregnancies. Inclusion criteria were willing to participating in study, patients’ age ranged from 18 to 45 years, gestational age ranged between 38-41 completed weeks of gestation, single pregnancy, being married, Iranian nationality, having no history of systemic diseases (diabetes, hypertension, known anemia, autoimmune or inflammatory disease and other diseases requiring special diet), no smoking or drinking alcohol, no drugs intake. Exclusion criteria were unwilling to continue the study. The CPR was calculated as the simple ratio between the middle cerebral artery PI and the umbilical artery PI. The study cohort was divided into 3 groups according to CPR cutoff of the 5th, 5-95th, 95th percentile according to gestational age. The following outcomes measures were considered: meconium-stained amniotic fluid, mode of delivery, 1 and 5-minute Apgar score, NICU admission, arterial cord pH, base excess.
Results: There are significant difference in AFI, arterial cord pH, arterial cord pH, base excess, Apgar score at minute 1 and 5 neonatal cord PH, NICU admission rate, cesarean delivery according to CPR categories (P < 0.05). AFI, Apgar score at minute 1 and 5 neonatal cord PH were lower in CPR < 5% compared another group. NICU admission rate and cesarean delivery were higher in CPR < 5% compared another group. Fetal distress was the most important indication for cesarean delivery in all CPR groups (35.13 %, 21.21 % and 11.8% respectively).
Conclusion: In conclusion, it's seemed that CPR index is useful in clinical practice in prenatal outcomes monitoring of term uncomplicated women in order to select those at high risk.
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| Keyword:
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cesarean, cerebroplacental ratio, perinatal.
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.01.740
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| Download:
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