Prediction of adverse perinatal outcome by cerebroplacental ratio in women undergoing induction of labor

Journal article


Fiolna, M., Kostiv, V., Anthoulakis, C., Akolekar, R. and Nicolaides, K.H. 2019. Prediction of adverse perinatal outcome by cerebroplacental ratio in women undergoing induction of labor. Ultrasound in Obstetrics and Gynecology. 53 (4), pp. 473-480. https://doi.org/10.1002/uog.20173
AuthorsFiolna, M., Kostiv, V., Anthoulakis, C., Akolekar, R. and Nicolaides, K.H.
Abstract

Objective: To investigate the performance of screening for adverse perinatal outcome by the cerebroplacental ratio (CPR) measured within 24 hours of induction of labor.

Methods: This was a prospective observational study in 1,902 singleton pregnancies undergoing induction of labor at ≥ 37 weeks’ gestation. Doppler ultrasound was used to measure the pulsatility index (PI) in the umbilical artery (UA) and fetal middle cerebral artery (MCA) before induction of labor. The measured UA PI and MCA PI and their ratio were converted to multiples of the median (MoM) after adjustment for gestational age. Univariate and multivariate logistic regression analysis was used to determine whether CPR improved the prediction of adverse perinatal outcome that was provided by maternal characteristics, medical history and obstetric factors. The detection rate (DR) and false-positive rate (FPR) of screening by CPR were estimated for cesarean section for presumed fetal distress and neonatal adverse outcome, which included umbilical arterial or venous cord blood pH ≤7 and ≤7.1, respectively, 5-minute Apgar score <7, admission to the neonatal intensive care unit (NICU) for >24 hours, or hypoxic ischemic encephalopathy.

Results: A combination of maternal and pregnancy characteristics, including age, weight, racial origin, previous obstetric history, preeclampsia, gestational age at delivery and amniotic fluid volume, identified 39% of pregnancies requiring cesarean section for fetal distress at FPR of 10%; addition of CPR did not improve the performance of screening. In screening for adverse neonatal outcome by a combination of parity and CPR the DR was 17% at FPR of 10%.

Conclusion: Low CPR, measured within 24 hours of induction of labor, is associated with increased risk of cesarean section for fetal distress and adverse neonatal outcome, but the performance of CPR for such surrogates of adverse perinatal outcome is poor.

KeywordsInduction of labor; Cesarean section; Fetal distress; Doppler ultrasound; Cerebro-placental ratio; Adverse neonatal outcome
Year2019
JournalUltrasound in Obstetrics and Gynecology
Journal citation53 (4), pp. 473-480
PublisherWiley
ISSN1469-0705
0960-7692
Digital Object Identifier (DOI)https://doi.org/10.1002/uog.20173
Official URLhttp://doi.org/10.1002/uog.20173
Publication dates
Online13 Nov 2018
Online04 Mar 2019
PrintApr 2019
Publication process dates
Accepted01 Nov 2018
Deposited03 Jun 2020
Accepted author manuscript
Output statusPublished
References

1. Nicolaides KH, Soothill PW, Rodeck CH, Campbell S. Ultrasound guided sampling of umbilical cord and placental blood to assess fetal wellbeing. Lancet 1986; 1:1065–1067.
2. Soothill PW, Nicolaides KH, Campbell S. Prenatal asphyxia, hyperlacticaemia,hypoglycaemia and erythroblastosis in growth retarded fetuses. BMJ 1987; 294:1051–1053.
3. Nicolaides KH, Bilardo KM, Soothill PW, Campbell S. Absence of end diastolic frequencies in the umbilical artery a sign of fetal hypoxia and acidosis. BMJ 1988;297: 1026–1027.
4. Vyas S, Nicolaides KH, Bower S, Campbell S. Middle cerebral artery flowvelocity waveforms in fetal hypoxaemia. Br J Obstet Gynaecol 1990; 97:797–803.
5. Bahado-Singh RO, Kovanci E, Jeffres A, Oz U, Deren O, Copel J, Mari G.The Doppler cerebroplacental ratio and perinatal outcome in intrauterine growth restriction. Am J Obstet Gynecol 1999; 180: 750–756.
6. Gramellini D, Folli MC, Raboni S, Vadora E, Merialdi A. Cerebral-umbilical Dopplerratio as a predictor of adverse perinatal outcome. Obstet Gynecol 1992; 79: 416–420.
7. DeVore GR. The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA foetuses. Am J Obstet Gynecol 2015; 213: 5–15.
8. Prior T, Mullins E, Bennett P, Kumar S. Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study. Am J ObstetGynecol 2013; 208: 124.e1–6.
9. Morales-Rosell´o J, Khalil A, Morlando M, Papageorghiou A, Bhide A,Thilaganathan B. Fetal Doppler changes as a marker of failure to reach growth potential at term. Ultrasound Obstet Gynecol 2014; 43: 303–310.
10. Khalil AA, Morales-Rosello J, Elsadigg M, Khan N, Papageorghiou A, Bhide A,Thilaganathan B. The association between fetal Doppler and admission to neonatal unit at term. Am J Obstet Gynecol 2015; 213: 57.e1–7.
11. Khalil AA, Morales-Rosello J, Morlando M, Hannan H, Bhide A, Papageorghiou A,Thilaganathan B. Is fetal cerebroplacental ratio an independent predictor of intrapartum fetal compromise and neonatal unit admission? Am J Obstet Gynecol2015; 213: 54.e1–10.
12. Khalil A, Morales-Rosello J, Khan N, Nath M, Agarwal P, Bhide A, Papageorghiou A,Thilaganathan B. Is cerebroplacental ratio a marker of impaired fetal growth velocity and adverse pregnancy outcome? Am J Obstet Gynecol 2017; 216: 606.e1–10.
13. Bakalis S, Akolekar R, Gallo DM, Poon LC, Nicolaides KH. Umbilical and fetal middle cerebral artery Doppler at 30–34 weeks’ gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol 2015; 45: 409–420.
14. Akolekar R, Syngelaki A, Gallo DM, Poon LC, Nicolaides KH. Umbilical and fetal middle cerebral artery Doppler at 35–37 weeks’ gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol 2015; 46: 82–92.
15. Nicolaides KH, Wright D, Syngelaki A, Wright A, Akolekar R. Fetal MedicineFoundation fetal and neonatal population weight charts. Ultrasound Obstet Gynecol2018;52: 44–51.
16. Ciobanu A, Wright A, Syngelaki A, Wright D, Akolekar R, Nicolaides KH. FetalMedicine Foundation reference ranges for umbilical artery and middle cerebral artery pulsatility index and cerebroplacental ratio. Ultrasound Obstet Gynecol 2019; 53:465–472.
17. Snijders RJ, Nicolaides KH. Fetal biometry at 14–40 weeks’ gestation. UltrasoundObstet Gynecol 1994; 4: 34–48.
18. Robinson HP, Fleming JE. A critical evaluation of sonar crown rump length measurements. BrJObstetGynaecol1975; 82: 702– 710.
19. Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 1993; 39: 561–577.
20. Bilardo CM, Nicolaides KH, Campbell S. Doppler measurements of fetal and uteroplacental circulations: relationship with umbilical venous blood gases measured at cordocentesis. Am J Obstet Gynecol 1990; 162: 115–120.
21. Garcia-Simon R, Figueras F, Savchev S, Fabre E, Gratacos E, Oros D. Cervicalcondition and fetal cerebral Doppler as determinants of adverse perinatal outcome after labor induction for late-onset small-for-gestational-age fetuses. UltrasoundObstet Gynecol 2015; 46: 713–717.
22. Fratelli N, Mazzoni G, Maggi C, Gerosa V, Lojacono A, Prefumo F. Cerebroplacentalratio before induction of labour in normally grown fetuses at term and intrapartum fetal compromise. Eur J Obstet Gynecol Reprod Biol 2018; 227; 78–80.

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Vigneswaran, T. V., Zidere, V., Chivers, S., Charakida, M., Akolekar, R. and Simpson, J. M. 2019. Impact of prospective measurement of outflow tracts in the prediction of coarctation of the aorta. Ultrasound in Obstetrics and Gynecology. https://doi.org/10.1002/uog.21957
Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with high nuchal translucency, tricuspid regurgitation and abnormal flow in the ductus venosus
Minnella, G. P., Crupano, F. M., Syngelaki, A., Zidere, V., Akolekar, R. and Nicolaides, K. H. 2019. Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with high nuchal translucency, tricuspid regurgitation and abnormal flow in the ductus venosus. Ultrasound in Obstetrics and Gynecology. 55 (5), pp. 637-644. https://doi.org/10.1002/uog.21956
Screening for pre-eclampsia using sFlt-1/PlGF ratio cut-off of 38 at 30-37 weeks' gestation
Dragan, I., Georgiou, T., Prodan, N., Akolekar, R. and Nicolaides, K. H. 2017. Screening for pre-eclampsia using sFlt-1/PlGF ratio cut-off of 38 at 30-37 weeks' gestation. Ultrasound in Obstetrics and Gynecology. 49 (1), pp. 73-77. https://doi.org/10.1002/uog.17301
Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R. and Nicolaides, K. H. 2016. Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 47 (3), pp. 308-315. https://doi.org/10.1002/uog.14898
Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R. and Nicolaides, K. H. 2016. Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 47 (2), pp. 194-202. https://doi.org/10.1002/uog.14928
Screening for trisomies by cell-free DNA testing of maternal blood: consequences of a failed result
Revello, R., Sarno, L., Ispas, A., Akolekar, R. and Nicolaides, K. H. 2016. Screening for trisomies by cell-free DNA testing of maternal blood: consequences of a failed result. Ultrasound in Obstetrics and Gynecology. 47 (6), pp. 698-704. https://doi.org/10.1002/uog.15851
Metformin versus placebo in obese pregnant women without diabetes mellitus
Syngelaki, A., Nicolaides, K. H., Balani, J., Hyer, S., Akolekar, R., Kotecha, R., Pastides, A. and Shehata, H. 2016. Metformin versus placebo in obese pregnant women without diabetes mellitus. New England Journal of Medicine. 374, pp. 434-43. https://doi.org/10.1056/NEJMoa1509819
Prospective first-trimester screening for trisomies by cell-free DNA testing of maternal blood in twin pregnancy
Sarno, L., Revello, R., Hanson, E., Akolekar, R. and Nicolaides, K. H. 2016. Prospective first-trimester screening for trisomies by cell-free DNA testing of maternal blood in twin pregnancy. Ultrasound in Obstetrics and Gynecology. 47 (6), pp. 705-11. https://doi.org/10.1002/uog.15913
Prediction of stillbirth from biochemical and biophysical markers at 11-13 weeks
Mastrodima, S., Akolekar, R., Yerlikaya, G., Tzelepis, T. and Nicolaides, K. H. 2016. Prediction of stillbirth from biochemical and biophysical markers at 11-13 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 613-617. https://doi.org/10.1002/uog.17289
Prediction of stillbirth from maternal demographic and pregnancy characteristics
Yerlikaya, G., Akolekar, R., McPherson, K., Syngelaki, A. and Nicolaides, K. H. 2016. Prediction of stillbirth from maternal demographic and pregnancy characteristics. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 607-612. https://doi.org/10.1002/uog.17290
Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies
Peeva, G., Chaveeva, P., Gil Guevara, E., Akolekar, R. and Nicolaides, K. H. 2016. Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies. Fetal Diagnosis and Therapy. 40 (3), pp. 174-180. https://doi.org/10.1159/000443792
Prediction of stillbirth from maternal factors, fetal biometry and uterine artery Doppler at 19-24 weeks
Akolekar, R., Tokunaka, M., Ortega, N., Syngelaki, A. and Nicolaides, K. H. 2016. Prediction of stillbirth from maternal factors, fetal biometry and uterine artery Doppler at 19-24 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 624-630. https://doi.org/10.1002/uog.17295
Prediction of stillbirth from placental growth factor at 11-13 weeks
Akolekar, R., Machuca, M., Mendes, M., Paschos, V. and Nicolaides, K. H. 2016. Prediction of stillbirth from placental growth factor at 11-13 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 618-623. https://doi.org/10.1002/uog.17288
Prediction of stillbirth from placental growth factor at 19-24 weeks
Aupont J. E., Akolekar, R., Illian, A., Neonakis, S. and Nicolaides, K. H. 2016. Prediction of stillbirth from placental growth factor at 19-24 weeks. Ultrasound in Obstetrics and Gynecology. 48 (5), pp. 631-635. https://doi.org/10.1002/uog.17229
Biophysical and biochemical markers at 35-37 weeks' gestation in the prediction of adverse perinatal outcome
Valiño, N., Giunta, G., Gallo, D. M., Akolekar, R. and Nicolaides, K. H. 2015. Biophysical and biochemical markers at 35-37 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in Obstetrics and Gynecology. 47 (2), pp. 203-209. https://doi.org/10.1002/uog.15663