Comparison of outcome of Low-risk and High-risk pregnancies based on fetal cerebroplacental ratio assessed by Doppler studies

FGRis normally used to refer to small fetuses with higher risk for fetal inuterodeterioration, stillbirth and overall poorer perinatal outcome as compared withnormally grown fetuses. They are associated with Doppler signs suggestinghemodynamic redistribution as a reflection of fetal adaptation to undernutrition /hypoxia, histological and biochemical signs of placental disease anda higher risk of preeclampsia. The term SGA has been used to differentiate asubgroup of small fetuses that do not present the changes described above. Whilethe concepts of FGR and SGA may be clear, distinction of ‘True FGR’ in clinicalpractice can be challenging.

Population based seriesshow that prenatal identification of SGA babies’ results in a reduction ofadverse perinatal outcome and stillbirth. However, most SGA babies remainunnoticed until birth, even when routine third trimester ultrasound isperformed. In late SGA fetuses, abnormal CPR is present before deliveryin 20-25% of the cases. We propose that low fetal CPR is associated withadverse perinatal outcome. This study aims to evaluate the Cerebro PlacentalRatio, which is the ratio of Pulsatality Index of fetal middle cerebral and UmbilicalArtery, in normal and high-risk pregnancies during 28 – 36 weeks of gestationand compare the fetal and neonatal outcome.