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Clinical significance of cerebroplacental ratio

Erkan Kalafat1,2, Asma Khalil1,3

  • 1Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.

Current Opinion in Obstetrics & Gynecology
|October 10, 2018
PubMed

Insights

The cerebroplacental ratio (CPR) aids in identifying fetuses at risk of growth restriction, a key factor in stillbirth. This ratio is a valuable tool for antenatal surveillance and risk stratification.

Area of Science:

  • Perinatal Medicine
  • Fetal Medicine
  • Obstetrics

Background:

  • Stillbirth often accompanies fetal growth restriction, necessitating early identification of at-risk fetuses.
  • Antenatal surveillance plays a crucial role in mitigating stillbirth risk.

Purpose of the Study:

  • To critically evaluate the clinical utility of the cerebroplacental ratio (CPR) in antenatal surveillance.
  • To assess CPR's effectiveness in identifying fetuses at risk of growth disorders.

Main Methods:

  • Review of current evidence on CPR's application in antenatal care.
  • Comparative analysis of CPR with other Doppler assessments (MCA, UA).

Main Results:

  • CPR is a superior predictor of adverse outcomes compared to isolated MCA or UA Doppler.
  • CPR's predictive value is higher in suspected small-for-gestational age (SGA) fetuses than appropriate-for-gestational age (AGA) fetuses.
  • CPR aids in risk stratification for SGA fetuses, guiding delivery timing and predicting neonatal care unit admission.

Conclusions:

  • CPR serves as a valuable surrogate for suboptimal fetal growth and intrauterine hypoxia.
  • CPR is associated with increased risks of intrapartum compromise, abnormal growth velocity, and lower birthweight, even in AGA fetuses.
  • Further research is needed to establish standardized CPR cut-offs and clarify its role in predicting specific adverse outcomes like acidosis in AGA fetuses.
Abstract

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