ABSTRACT
OBJECTIVE: The current study aims to assess the efficacy of fetal middle cerebral artery/umbilical artery pulsatility index ratio (cerebroplacental ratio CPR) in predicting the occurrence of adverse perinatal outcomes in pregnancies complicated with severe pre-eclampsia. MATERIALS AND METHODS: This cohort study included 100 pregnant women between 34 and 40â¯weeks of gestation attended the labor ward and diagnosed with severe pre-eclampsia. Doppler evaluation was carried out to measure the CPR. Apgar score and fetal umbilical artery pH were assessed within 5â¯min of delivery. The rate of neonatal intensive care unit (NICU) admission was obtained. RESULTS: Apgar score at 5â¯min >7 was in 82 cases (82%) and 12 cases (12%) scoredâ¯<â¯7. Fetal blood PH was >7.2 in 67% of cases while 33% of cases had PH <7.2. As regard the NICU admission; 66% of neonates did not need admission while 34% of neonates were admitted to the NICU. There was a significant association between CPR and low Apgar score at 5â¯min (Pâ¯<â¯0.001). The sensitivity of CPR in detection of Apgar score <7 was 50%, and specificity 88.1%. CPR had a poor predictive value of the low umbilical artery PH <7.2 (Pâ¯=â¯0.318) with 43.75% sensitivity and 69.05% specificity. There was a significant association between CPR and NICU admission (Pâ¯=â¯0.009). CONCLUSIONS: Adding CPR ratio to routine antepartum fetal surveillance from 34â¯weeks gestation may help with patient counseling regarding adverse neonatal outcomes for women with severe pre-eclampsia as there is a strong correlation between it and adverse neonatal outcomes.