Reduced fetal movements and cerebroplacental ratio: evidence for worsening fetal hypoxemia

ABSTRACT Objective To investigate the fetal cerebroplacental ratio (CPR) in women presenting with reduced fetal movements (RFM). Methods This was a retrospective cohort study of data collected over an 8‐year period at a fetal medicine unit at a tertiary referral center. The cohort comprised 4500 singleton pregnancies presenting with RFM at or after 36 weeks' gestation and 1527 control pregnancies at a similar gestational age without RFM. Fetal biometry and Doppler parameters were recorded and converted into centiles and multiples of the median (MoM). CPR was defined as the ratio between the fetal middle cerebral artery (MCA) pulsatility index (PI) and the umbilical artery (UA) PI. Subgroup analysis for fetal size and for single vs multiple episodes of RFM was performed. Results Compared with controls, pregnancies with RFM had lower MCA‐PI MoM (median, 0.95 vs 0.97; P