The role of cerebroplacental ratio in predicting fetal growth restriction

doi:10.3877/cma.j.issn.2095-3259.2019.01.010

Abstract

Abstract:

Objective

To explore the role of cerebroplactic ratio (CPR) in predicting fetal growth restriction (FGR).

Methods

The clinical data of 52 pregnant women with FGR and 49 normal pregnant women, who were admitted to the Second Affiliated Hospital of Guangzhou Medical University from January 2015 to December 2017, were retrospectively analyzed. ROC curve was used to analyze the prediction of adverse pregnancy outcome of FGR by cerebral placenta rate, umbilical artery flow and middle cerebral artery blood flow. And the sensitivity and specificity of FGR diagnosed were analyzed by calculating area under curve (AUC) and comparing each blood flow index.

Results

The CPR at 28-31^{+ 6} weeks of gestation and 32-36^{+ 6} weeks of gestation were superior to those of umbilical artery and middle cerebral artery blood flow. AUC values at 28-31^{+ 6} weeks of gestation and 32-36^{+ 6} weeks of gestation were 0.82 and 0.96, with cutoff values of 1.74 and 1.59. Their sensitivity was 96% and 90%, and the specificity is 79% and 97%, respectively.

Conclusion

CPR was clinically useful as a predictor of FGR.

Key words: Fetal growth retardation, Placental insufficiency, Middle cerebral artery, Ultrasonography, doppler, color

Lanzhen Zhang, Chenyu Gou, Xiaolan Liu. The role of cerebroplacental ratio in predicting fetal growth restriction[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2019, 08(01): 45-49.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhckjjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3259.2019.01.010

https://zhckjjdzzz.cma-cmc.com.cn/EN/Y2019/V08/I01/45

Figures/Tables 6

References 13

[1]	治晶，怀莹莹，吴虹，等. 胎儿生长受限预测方法的研究进展[J]. 现代妇产科进展，2015, 24(4): 315-317.
[2]	陈梦捷，张晓红，黄振宇，等. 有无母体合并症及并发症的胎儿生长受限临床对比分析[J]. 实用妇产科杂志，2013, 29(2): 115-119.
[3]	Tani JC,Boelen MR,Schmitz DM, et al. Correlation between Doppler flow patterns in Growth-restricted fetuses and neonatal circulation [J]. Ultrasound Obstet Gynecol, 2016, 48(2)：210-216.
[4]	Todros T,Piccoli E,Rolfo A, et al. Review: Feto-placental vascularization: A multifaceted Approach [J]. Placenta, 2011, 32(S2): S165-S169.
[5]	Nassr AA,Abdelmagied AM,Shazly SA, et al. Fetal cerebro-placental ratio and adverse perinatal outcome systematic review and meta-analysis of the association and diagnostic performance [J]. J Perinat Med, 2016, 44(2): 249-256.
[6]	Kupferminc MJ，Rimo E，Many A，et al.Low molecular weight heparin treatment during subsequent pregnancies of women with inherited thrombophilia and previous severe pregnancy complications [J]. Maternal-Fetal Neonatal Med, 2011, 24(8)：1042-1045.
[7]	杨玉英，江森，张运，等. 胎儿脑及脐动脉血流检测的临床意义[J]. 中华妇产科杂志，1995, 30(2): 70-73.
[8]	Figueira CO,Surita FG,Dertkigil MS, et al. Fetal Hemodynamic Parameters in Low Risk Pregnancies: Doppler Velocimetry of Uterine, Umbilical, and Middle Cerebral Artery [J]. Scientific World Journal, 2016, 2016：1693704.
[9]	Fardiazar Z,Atashkhouei S,Yosefzad Y, et al. Comparison of fetal middle cerebral arteries, umbilical and uterine artery color Doppler ultrasound with blood gas analysis in pregnancy complicated by FGR [J]. Iran J Reprod Med, 2013, 11(1): 47-51.
[10]	Karlsen HO,Ebbing C,Rasmussen S, et al. Use of conditional centiles of middle cerebral artery pulsatility index and cerebro-placental ratio in the prediction of adverse perinatal outcomes[J]. Acta Obstet Gynecol Scand, 2016, 95(6): 690-696.
[11]	任金河，梁淑霞，张丽君. 胎儿脑-胎盘率(PI_MCA/PI_UA)测算的临床意义[J]. 中华超声医学杂志，2001, 17(5): 379-381.
[12]	De Vore GR. The importance of the cerebro-placental ratio in the evaluation of fetal well-being in SGA and AGA fetuses [J]. Am J Obstet Gynecol, 2015, 213(1): 5-15.
[13]	鲍静. 脑胎盘率诊断胎儿宫内缺氧的研究进展[J]. 医疗装备，2018, 31(19): 203-204.

组别	例数	脐动脉			大脑中动脉			CPR
组别	例数	S/D	PI	RI	S/D	PI	RI	CPR
FGR组	22	3.00±0.40	1.04±0.14	0.69±0.08	5.28±0.79	1.59±0.22	0.76±0.07	1.56±0.22
对照组	19	2.60±0.30	0.89±0.14	0.60±0.06	6.28±1.38	1.87±0.43	0.90±0.07	2.08±0.60
t值	?	3.54	3.43	4.31	2.89	2.49	2.62	4.19
P值	?	0.001	0.001	<0.05	0.006	0.019	0.012	0.001

组别	例数	脐动脉			大脑中动脉			CPR
组别	例数	S/D	PI	RI	S/D	PI	RI	CPR
FGR组	22	3.00±0.40	1.04±0.14	0.69±0.08	5.28±0.79	1.59±0.22	0.76±0.07	1.56±0.22
对照组	19	2.60±0.30	0.89±0.14	0.60±0.06	6.28±1.38	1.87±0.43	0.90±0.07	2.08±0.60
t值	?	3.54	3.43	4.31	2.89	2.49	2.62	4.19
P值	?	0.001	0.001	<0.05	0.006	0.019	0.012	0.001

血流类别	?	截断值	灵敏度(%)	特异度(%)	AUC
脐血流	S/D	2.86	68	84	0.75
?	PI	0.93	82	63	0.77
?	RI	0.67	68	89	0.80
大脑中动脉	S/D	4.28	59	79	0.72
?	PI	1.36	41	95	0.69
?	RI	0.74	55	89	0.72
CPR	?	1.74	96	79	0.82

血流类别	?	截断值	灵敏度(%)	特异度(%)	AUC
脐血流	S/D	2.86	68	84	0.75
?	PI	0.93	82	63	0.77
?	RI	0.67	68	89	0.80
大脑中动脉	S/D	4.28	59	79	0.72
?	PI	1.36	41	95	0.69
?	RI	0.74	55	89	0.72
CPR	?	1.74	96	79	0.82

组别	例数	脐动脉			大脑中动脉			CPR
组别	例数	S/D	PI	RI	S/D	PI	RI	CPR
FGR组	30	2.97±0.27	1.00±0.11	0.69±0.08	4.04±0.40	1.58±0.26	0.73±0.07	1.37±0.19
对照组	30	2.38±0.37	0.84±0.14	0.57±0.06	4.86±0.49	1.84±0.15	0.84±0.07	2.09±0.35
t值	?	7.03	6.24	4.58	7.16	4.54	6.18	9.88
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

Please choose a citation manager

Content to export