Association between Fetal Middle Cerebral Artery to Umbilical Artery Doppler Ratio with Fetal Distress in 38-40 Weeks of Gestation

Background and Objective: Knowing the factors affecting fetal distress is of particular importance in improving prognosis in newborns. The study aimed to determine the relationship between fetal middle cerebral artery pulsatility indexes to umbilical artery Doppler ratio with fetal distress in 38-40 weeks of gestation.Materials and Methods: In this prospective cohort, 181 consecutive pregnant women with 38 to 40 weeks of gestational age were selected by a non-random from January 2016 to January 2017. Women with labor pain and embryos with chromosomal and structural disorder were excluded. Color Doppler sonography was done for all of them, the association of this ratio with fetal distress consequently was assessed as well. Results: In this study, there were 1.1%, 5.5%, 11.6%, 12.2%, 0.6%, 10.5%, 11.6%, 10.5%, and 3.9% with abnormal amniotic fluid index (AFI), low birth weight (< 2500 g), emergency cesarean, neonatal intensive care unit (NICU) admission, low 5th minute Apgar (< 7), abnormal fetal monitoring, fetal distress, meconium aspiration syndrome, and respiratory distress were present, respectively. The mean cerebroplacental ratio (CPR) was 1.9. There was a significant association between low fetal middle cerebral artery pulsatility index to umbilical artery Doppler ratio with fetal distress, abnormal monitoring, and urgent cesarean (P=0.006). The cutoff 1.94 led to sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 80.95%, 50%, 17.5%, and 95.2%, respectively. Conclusion: According to the results, it may be concluded that low fetal middle cerebral artery to umbilical artery ratio in 38 weeks is predictive for fetal distress in 38-40 weeks of gestation.

کلیدواژه ها:

Cerebroplacental ratio ، Color Doppler ، Middle Cerebral Artery Doppler ، Pulsatility Index ، Umbilical Artery Doppler