Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study
Introduction: The role of cerebroplacental ratio (CPR) or umbilicocerebral ratio (UCR) to predict adverse intrapartum and perinatal outcomes in pregnancies complicated by late fetal growth restriction (FGR) remains controversial. Methods: This was a multicenter, retrospective cohort study involving...
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| Veröffentlicht in: | Fetal diagnosis and therapy 2021-07, Vol.48 (6), p.448-456 |
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| creator | Di Mascio, Daniele Herraiz, Ignacio Villalain, Cecilia Buca, Danilo Morales-Rossello, Jose Loscalzo, Gabriela Sileo, Filomena Giulia Finarelli, Alessandra Bertucci, Emma Facchinetti, Fabio Rizzo, Giuseppe Brunelli, Roberto Giancotti, Antonella Muzii, Ludovico Maruotti, Giuseppe Maria Carbone, Luigi D’Amico, Alice Tinari, Sara Morelli, Roberta Cerra, Chiara Nappi, Luigi Greco, Pantaleo Liberati, Marco Galindo, Alberto D’Antonio, Francesco |
| description | Introduction: The role of cerebroplacental ratio (CPR) or umbilicocerebral ratio (UCR) to predict adverse intrapartum and perinatal outcomes in pregnancies complicated by late fetal growth restriction (FGR) remains controversial. Methods: This was a multicenter, retrospective cohort study involving 5 referral centers in Italy and Spain, including singleton pregnancies complicated by late FGR, as defined by Delphi consensus criteria, with a scan 1 week prior to delivery. The primary objective was to compare the diagnostic accuracy of the CPR and UCR for the prediction of a composite adverse outcome, defined as the presence of either an adverse intrapartum outcome (need for operative delivery/cesarean section for suspected fetal distress) or an adverse perinatal outcome (intrauterine death, Apgar score |
| doi_str_mv | 10.1159/000516443 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_gale_healthsolutions_A709901758</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A709901758</galeid><sourcerecordid>A709901758</sourcerecordid><originalsourceid>FETCH-LOGICAL-c432t-cef96fd5842d213f4dc25a23db55b567a34319de59bae6de55cb0df783e6bb8d3</originalsourceid><addsrcrecordid>eNqNkt9rFDEQxxdRbK0--C4SEETRq8lmsz98O1avCicttX1e8mP2LrqbrEm2x_2P_lFmvfO00AcJJEPmM9_MTCZJnhJ8Sgir3mGMGcmzjN5LjkmWkllV5dn9aGPCZrSkxVHyyPtvESsLmj9MjmhGKE4Ldpz8rG0_cKe9NUhA2AAYVIMD4ezQcQkm8A5d8qAt4kah617oTksrfyMHlzbowoHSMmizQnN1A84DugCnDZ8EzscgbQ97bmW4kRo8mt6OajyAQmKLltFAC5gCzpzdhDW6BB_cpGrNezRHX8Yu6CkncG-jLzjrB4jeG0Bfw6i2j5MHLe88PNmfJ8n14uNV_Wm2PD_7XM-XM5nRNMwktFXeKlZmqUoJbTMlU8ZTqgRjguUFpxkllQJWCQ55PJkUWLVFSSEXolT0JHm10x2c_THGHJteewldxw3Y0Tcpy0hRlmWWR_TFDl3xDhptWhsclxPezAtcVZgUrIzU6R1UXAr62G0DrY73twJe_hOwBt6FtbfdOHXK3wZf70AZm-UdtM3gdM_dtiG4mYanOQxPZJ_vyxpFD-pA_pmWCLzZARsQtvXxD42EAxaF8jylcY8WJpEu_5-udZgmydR2NOFv175ztwJ3CFp8uNrl2gyqjdSzO6l9Ob8Ad0X3SA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2541788846</pqid></control><display><type>article</type><title>Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study</title><source>Karger Journal Archive Collection</source><source>MEDLINE</source><source>Karger Journals</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>Alma/SFX Local Collection</source><creator>Di Mascio, Daniele ; Herraiz, Ignacio ; Villalain, Cecilia ; Buca, Danilo ; Morales-Rossello, Jose ; Loscalzo, Gabriela ; Sileo, Filomena Giulia ; Finarelli, Alessandra ; Bertucci, Emma ; Facchinetti, Fabio ; Rizzo, Giuseppe ; Brunelli, Roberto ; Giancotti, Antonella ; Muzii, Ludovico ; Maruotti, Giuseppe Maria ; Carbone, Luigi ; D’Amico, Alice ; Tinari, Sara ; Morelli, Roberta ; Cerra, Chiara ; Nappi, Luigi ; Greco, Pantaleo ; Liberati, Marco ; Galindo, Alberto ; D’Antonio, Francesco</creator><creatorcontrib>Di Mascio, Daniele ; Herraiz, Ignacio ; Villalain, Cecilia ; Buca, Danilo ; Morales-Rossello, Jose ; Loscalzo, Gabriela ; Sileo, Filomena Giulia ; Finarelli, Alessandra ; Bertucci, Emma ; Facchinetti, Fabio ; Rizzo, Giuseppe ; Brunelli, Roberto ; Giancotti, Antonella ; Muzii, Ludovico ; Maruotti, Giuseppe Maria ; Carbone, Luigi ; D’Amico, Alice ; Tinari, Sara ; Morelli, Roberta ; Cerra, Chiara ; Nappi, Luigi ; Greco, Pantaleo ; Liberati, Marco ; Galindo, Alberto ; D’Antonio, Francesco</creatorcontrib><description>Introduction: The role of cerebroplacental ratio (CPR) or umbilicocerebral ratio (UCR) to predict adverse intrapartum and perinatal outcomes in pregnancies complicated by late fetal growth restriction (FGR) remains controversial. Methods: This was a multicenter, retrospective cohort study involving 5 referral centers in Italy and Spain, including singleton pregnancies complicated by late FGR, as defined by Delphi consensus criteria, with a scan 1 week prior to delivery. The primary objective was to compare the diagnostic accuracy of the CPR and UCR for the prediction of a composite adverse outcome, defined as the presence of either an adverse intrapartum outcome (need for operative delivery/cesarean section for suspected fetal distress) or an adverse perinatal outcome (intrauterine death, Apgar score <7 at 5 min, arterial pH <7.1, base excess of >−11 mEq/mL, or neonatal intensive care unit admission). Results: Median CPR absolute values (1.11 vs. 1.22, p = 0.018) and centiles (3 vs. 4, p = 0.028) were lower in pregnancies with a composite adverse outcome than in those without it. Median UCR absolute values (0.89 vs. 0.82, p = 0.018) and centiles (97 vs. 96, p = 0.028) were higher. However, the area under the curve, 95% confidence interval for predicting the composite adverse outcome showed a poor predictive value: 0.580 (0.512–0.646) for the raw absolute values of CPR and UCR, and 0.575 (0.507–0.642) for CPR and UCR centiles adjusted for gestational age. The use of dichotomized values (CPR <1, UCR >1 or CPR <5th centile, UCR >95th centile) did not improve the diagnostic accuracy. Conclusion: The CPR and UCR measured in the week prior delivery are of low predictive value to assess adverse intrapartum and perinatal outcomes in pregnancies with late FGR.</description><identifier>ISSN: 1015-3837</identifier><identifier>EISSN: 1421-9964</identifier><identifier>DOI: 10.1159/000516443</identifier><identifier>PMID: 34130275</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject>Cesarean Section ; Doppler ultrasonography ; Female ; Fetal Growth Retardation - diagnostic imaging ; Fetus ; Growth retardation ; Humans ; Infant, Newborn ; Life Sciences & Biomedicine ; Methods ; Middle Cerebral Artery - diagnostic imaging ; Obstetrics & Gynecology ; Predictive Value of Tests ; Pregnancy ; Pregnancy Outcome ; Pulsatile Flow ; Research Article ; Retrospective Studies ; Science & Technology ; Stillbirth ; Ultrasonic imaging ; Ultrasonics in obstetrics ; Ultrasonography, Prenatal ; Umbilical Arteries - diagnostic imaging</subject><ispartof>Fetal diagnosis and therapy, 2021-07, Vol.48 (6), p.448-456</ispartof><rights>2021 S. Karger AG, Basel</rights><rights>2021 S. Karger AG, Basel.</rights><rights>COPYRIGHT 2021 S. Karger AG</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>7</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000662300600001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c432t-cef96fd5842d213f4dc25a23db55b567a34319de59bae6de55cb0df783e6bb8d3</citedby><cites>FETCH-LOGICAL-c432t-cef96fd5842d213f4dc25a23db55b567a34319de59bae6de55cb0df783e6bb8d3</cites><orcidid>0000-0002-2127-1876 ; 0000-0001-7380-0576 ; 0000-0002-6560-3393 ; 0000-0002-5525-4353 ; 0000-0002-9456-4100 ; 0000-0003-2020-9111 ; 0000-0001-6807-4944 ; 0000-0002-5178-3354 ; 0000-0002-1308-1474</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,2431,27931,27932,39265</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34130275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Mascio, Daniele</creatorcontrib><creatorcontrib>Herraiz, Ignacio</creatorcontrib><creatorcontrib>Villalain, Cecilia</creatorcontrib><creatorcontrib>Buca, Danilo</creatorcontrib><creatorcontrib>Morales-Rossello, Jose</creatorcontrib><creatorcontrib>Loscalzo, Gabriela</creatorcontrib><creatorcontrib>Sileo, Filomena Giulia</creatorcontrib><creatorcontrib>Finarelli, Alessandra</creatorcontrib><creatorcontrib>Bertucci, Emma</creatorcontrib><creatorcontrib>Facchinetti, Fabio</creatorcontrib><creatorcontrib>Rizzo, Giuseppe</creatorcontrib><creatorcontrib>Brunelli, Roberto</creatorcontrib><creatorcontrib>Giancotti, Antonella</creatorcontrib><creatorcontrib>Muzii, Ludovico</creatorcontrib><creatorcontrib>Maruotti, Giuseppe Maria</creatorcontrib><creatorcontrib>Carbone, Luigi</creatorcontrib><creatorcontrib>D’Amico, Alice</creatorcontrib><creatorcontrib>Tinari, Sara</creatorcontrib><creatorcontrib>Morelli, Roberta</creatorcontrib><creatorcontrib>Cerra, Chiara</creatorcontrib><creatorcontrib>Nappi, Luigi</creatorcontrib><creatorcontrib>Greco, Pantaleo</creatorcontrib><creatorcontrib>Liberati, Marco</creatorcontrib><creatorcontrib>Galindo, Alberto</creatorcontrib><creatorcontrib>D’Antonio, Francesco</creatorcontrib><title>Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study</title><title>Fetal diagnosis and therapy</title><addtitle>FETAL DIAGN THER</addtitle><addtitle>Fetal Diagn Ther</addtitle><description>Introduction: The role of cerebroplacental ratio (CPR) or umbilicocerebral ratio (UCR) to predict adverse intrapartum and perinatal outcomes in pregnancies complicated by late fetal growth restriction (FGR) remains controversial. Methods: This was a multicenter, retrospective cohort study involving 5 referral centers in Italy and Spain, including singleton pregnancies complicated by late FGR, as defined by Delphi consensus criteria, with a scan 1 week prior to delivery. The primary objective was to compare the diagnostic accuracy of the CPR and UCR for the prediction of a composite adverse outcome, defined as the presence of either an adverse intrapartum outcome (need for operative delivery/cesarean section for suspected fetal distress) or an adverse perinatal outcome (intrauterine death, Apgar score <7 at 5 min, arterial pH <7.1, base excess of >−11 mEq/mL, or neonatal intensive care unit admission). Results: Median CPR absolute values (1.11 vs. 1.22, p = 0.018) and centiles (3 vs. 4, p = 0.028) were lower in pregnancies with a composite adverse outcome than in those without it. Median UCR absolute values (0.89 vs. 0.82, p = 0.018) and centiles (97 vs. 96, p = 0.028) were higher. However, the area under the curve, 95% confidence interval for predicting the composite adverse outcome showed a poor predictive value: 0.580 (0.512–0.646) for the raw absolute values of CPR and UCR, and 0.575 (0.507–0.642) for CPR and UCR centiles adjusted for gestational age. The use of dichotomized values (CPR <1, UCR >1 or CPR <5th centile, UCR >95th centile) did not improve the diagnostic accuracy. Conclusion: The CPR and UCR measured in the week prior delivery are of low predictive value to assess adverse intrapartum and perinatal outcomes in pregnancies with late FGR.</description><subject>Cesarean Section</subject><subject>Doppler ultrasonography</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Fetus</subject><subject>Growth retardation</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Life Sciences & Biomedicine</subject><subject>Methods</subject><subject>Middle Cerebral Artery - diagnostic imaging</subject><subject>Obstetrics & Gynecology</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pulsatile Flow</subject><subject>Research Article</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Stillbirth</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonics in obstetrics</subject><subject>Ultrasonography, Prenatal</subject><subject>Umbilical Arteries - diagnostic imaging</subject><issn>1015-3837</issn><issn>1421-9964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkt9rFDEQxxdRbK0--C4SEETRq8lmsz98O1avCicttX1e8mP2LrqbrEm2x_2P_lFmvfO00AcJJEPmM9_MTCZJnhJ8Sgir3mGMGcmzjN5LjkmWkllV5dn9aGPCZrSkxVHyyPtvESsLmj9MjmhGKE4Ldpz8rG0_cKe9NUhA2AAYVIMD4ezQcQkm8A5d8qAt4kah617oTksrfyMHlzbowoHSMmizQnN1A84DugCnDZ8EzscgbQ97bmW4kRo8mt6OajyAQmKLltFAC5gCzpzdhDW6BB_cpGrNezRHX8Yu6CkncG-jLzjrB4jeG0Bfw6i2j5MHLe88PNmfJ8n14uNV_Wm2PD_7XM-XM5nRNMwktFXeKlZmqUoJbTMlU8ZTqgRjguUFpxkllQJWCQ55PJkUWLVFSSEXolT0JHm10x2c_THGHJteewldxw3Y0Tcpy0hRlmWWR_TFDl3xDhptWhsclxPezAtcVZgUrIzU6R1UXAr62G0DrY73twJe_hOwBt6FtbfdOHXK3wZf70AZm-UdtM3gdM_dtiG4mYanOQxPZJ_vyxpFD-pA_pmWCLzZARsQtvXxD42EAxaF8jylcY8WJpEu_5-udZgmydR2NOFv175ztwJ3CFp8uNrl2gyqjdSzO6l9Ob8Ad0X3SA</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Di Mascio, Daniele</creator><creator>Herraiz, Ignacio</creator><creator>Villalain, Cecilia</creator><creator>Buca, Danilo</creator><creator>Morales-Rossello, Jose</creator><creator>Loscalzo, Gabriela</creator><creator>Sileo, Filomena Giulia</creator><creator>Finarelli, Alessandra</creator><creator>Bertucci, Emma</creator><creator>Facchinetti, Fabio</creator><creator>Rizzo, Giuseppe</creator><creator>Brunelli, Roberto</creator><creator>Giancotti, Antonella</creator><creator>Muzii, Ludovico</creator><creator>Maruotti, Giuseppe Maria</creator><creator>Carbone, Luigi</creator><creator>D’Amico, Alice</creator><creator>Tinari, Sara</creator><creator>Morelli, Roberta</creator><creator>Cerra, Chiara</creator><creator>Nappi, Luigi</creator><creator>Greco, Pantaleo</creator><creator>Liberati, Marco</creator><creator>Galindo, Alberto</creator><creator>D’Antonio, Francesco</creator><general>Karger</general><general>S. Karger AG</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2127-1876</orcidid><orcidid>https://orcid.org/0000-0001-7380-0576</orcidid><orcidid>https://orcid.org/0000-0002-6560-3393</orcidid><orcidid>https://orcid.org/0000-0002-5525-4353</orcidid><orcidid>https://orcid.org/0000-0002-9456-4100</orcidid><orcidid>https://orcid.org/0000-0003-2020-9111</orcidid><orcidid>https://orcid.org/0000-0001-6807-4944</orcidid><orcidid>https://orcid.org/0000-0002-5178-3354</orcidid><orcidid>https://orcid.org/0000-0002-1308-1474</orcidid></search><sort><creationdate>20210701</creationdate><title>Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study</title><author>Di Mascio, Daniele ; Herraiz, Ignacio ; Villalain, Cecilia ; Buca, Danilo ; Morales-Rossello, Jose ; Loscalzo, Gabriela ; Sileo, Filomena Giulia ; Finarelli, Alessandra ; Bertucci, Emma ; Facchinetti, Fabio ; Rizzo, Giuseppe ; Brunelli, Roberto ; Giancotti, Antonella ; Muzii, Ludovico ; Maruotti, Giuseppe Maria ; Carbone, Luigi ; D’Amico, Alice ; Tinari, Sara ; Morelli, Roberta ; Cerra, Chiara ; Nappi, Luigi ; Greco, Pantaleo ; Liberati, Marco ; Galindo, Alberto ; D’Antonio, Francesco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-cef96fd5842d213f4dc25a23db55b567a34319de59bae6de55cb0df783e6bb8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cesarean Section</topic><topic>Doppler ultrasonography</topic><topic>Female</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>Fetus</topic><topic>Growth retardation</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Life Sciences & Biomedicine</topic><topic>Methods</topic><topic>Middle Cerebral Artery - diagnostic imaging</topic><topic>Obstetrics & Gynecology</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pulsatile Flow</topic><topic>Research Article</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Stillbirth</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonics in obstetrics</topic><topic>Ultrasonography, Prenatal</topic><topic>Umbilical Arteries - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Mascio, Daniele</creatorcontrib><creatorcontrib>Herraiz, Ignacio</creatorcontrib><creatorcontrib>Villalain, Cecilia</creatorcontrib><creatorcontrib>Buca, Danilo</creatorcontrib><creatorcontrib>Morales-Rossello, Jose</creatorcontrib><creatorcontrib>Loscalzo, Gabriela</creatorcontrib><creatorcontrib>Sileo, Filomena Giulia</creatorcontrib><creatorcontrib>Finarelli, Alessandra</creatorcontrib><creatorcontrib>Bertucci, Emma</creatorcontrib><creatorcontrib>Facchinetti, Fabio</creatorcontrib><creatorcontrib>Rizzo, Giuseppe</creatorcontrib><creatorcontrib>Brunelli, Roberto</creatorcontrib><creatorcontrib>Giancotti, Antonella</creatorcontrib><creatorcontrib>Muzii, Ludovico</creatorcontrib><creatorcontrib>Maruotti, Giuseppe Maria</creatorcontrib><creatorcontrib>Carbone, Luigi</creatorcontrib><creatorcontrib>D’Amico, Alice</creatorcontrib><creatorcontrib>Tinari, Sara</creatorcontrib><creatorcontrib>Morelli, Roberta</creatorcontrib><creatorcontrib>Cerra, Chiara</creatorcontrib><creatorcontrib>Nappi, Luigi</creatorcontrib><creatorcontrib>Greco, Pantaleo</creatorcontrib><creatorcontrib>Liberati, Marco</creatorcontrib><creatorcontrib>Galindo, Alberto</creatorcontrib><creatorcontrib>D’Antonio, Francesco</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fetal diagnosis and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Mascio, Daniele</au><au>Herraiz, Ignacio</au><au>Villalain, Cecilia</au><au>Buca, Danilo</au><au>Morales-Rossello, Jose</au><au>Loscalzo, Gabriela</au><au>Sileo, Filomena Giulia</au><au>Finarelli, Alessandra</au><au>Bertucci, Emma</au><au>Facchinetti, Fabio</au><au>Rizzo, Giuseppe</au><au>Brunelli, Roberto</au><au>Giancotti, Antonella</au><au>Muzii, Ludovico</au><au>Maruotti, Giuseppe Maria</au><au>Carbone, Luigi</au><au>D’Amico, Alice</au><au>Tinari, Sara</au><au>Morelli, Roberta</au><au>Cerra, Chiara</au><au>Nappi, Luigi</au><au>Greco, Pantaleo</au><au>Liberati, Marco</au><au>Galindo, Alberto</au><au>D’Antonio, Francesco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study</atitle><jtitle>Fetal diagnosis and therapy</jtitle><stitle>FETAL DIAGN THER</stitle><addtitle>Fetal Diagn Ther</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>48</volume><issue>6</issue><spage>448</spage><epage>456</epage><pages>448-456</pages><issn>1015-3837</issn><eissn>1421-9964</eissn><abstract>Introduction: The role of cerebroplacental ratio (CPR) or umbilicocerebral ratio (UCR) to predict adverse intrapartum and perinatal outcomes in pregnancies complicated by late fetal growth restriction (FGR) remains controversial. Methods: This was a multicenter, retrospective cohort study involving 5 referral centers in Italy and Spain, including singleton pregnancies complicated by late FGR, as defined by Delphi consensus criteria, with a scan 1 week prior to delivery. The primary objective was to compare the diagnostic accuracy of the CPR and UCR for the prediction of a composite adverse outcome, defined as the presence of either an adverse intrapartum outcome (need for operative delivery/cesarean section for suspected fetal distress) or an adverse perinatal outcome (intrauterine death, Apgar score <7 at 5 min, arterial pH <7.1, base excess of >−11 mEq/mL, or neonatal intensive care unit admission). Results: Median CPR absolute values (1.11 vs. 1.22, p = 0.018) and centiles (3 vs. 4, p = 0.028) were lower in pregnancies with a composite adverse outcome than in those without it. Median UCR absolute values (0.89 vs. 0.82, p = 0.018) and centiles (97 vs. 96, p = 0.028) were higher. However, the area under the curve, 95% confidence interval for predicting the composite adverse outcome showed a poor predictive value: 0.580 (0.512–0.646) for the raw absolute values of CPR and UCR, and 0.575 (0.507–0.642) for CPR and UCR centiles adjusted for gestational age. The use of dichotomized values (CPR <1, UCR >1 or CPR <5th centile, UCR >95th centile) did not improve the diagnostic accuracy. Conclusion: The CPR and UCR measured in the week prior delivery are of low predictive value to assess adverse intrapartum and perinatal outcomes in pregnancies with late FGR.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>34130275</pmid><doi>10.1159/000516443</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2127-1876</orcidid><orcidid>https://orcid.org/0000-0001-7380-0576</orcidid><orcidid>https://orcid.org/0000-0002-6560-3393</orcidid><orcidid>https://orcid.org/0000-0002-5525-4353</orcidid><orcidid>https://orcid.org/0000-0002-9456-4100</orcidid><orcidid>https://orcid.org/0000-0003-2020-9111</orcidid><orcidid>https://orcid.org/0000-0001-6807-4944</orcidid><orcidid>https://orcid.org/0000-0002-5178-3354</orcidid><orcidid>https://orcid.org/0000-0002-1308-1474</orcidid></addata></record> |
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| ispartof | Fetal diagnosis and therapy, 2021-07, Vol.48 (6), p.448-456 |
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| language | eng |
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| source | Karger Journal Archive Collection; MEDLINE; Karger Journals; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; Alma/SFX Local Collection |
| subjects | Cesarean Section Doppler ultrasonography Female Fetal Growth Retardation - diagnostic imaging Fetus Growth retardation Humans Infant, Newborn Life Sciences & Biomedicine Methods Middle Cerebral Artery - diagnostic imaging Obstetrics & Gynecology Predictive Value of Tests Pregnancy Pregnancy Outcome Pulsatile Flow Research Article Retrospective Studies Science & Technology Stillbirth Ultrasonic imaging Ultrasonics in obstetrics Ultrasonography, Prenatal Umbilical Arteries - diagnostic imaging |
| title | Comparison between Cerebroplacental Ratio and Umbilicocerebral Ratio in Predicting Adverse Perinatal Outcome in Pregnancies Complicated by Late Fetal Growth Restriction: A Multicenter, Retrospective Study |
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