311 results match your criteria gestation cerebroplacental


How to define late Fetal growth Restriction.

Minerva Obstet Gynecol 2021 Apr 27. Epub 2021 Apr 27.

Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic), IDIBAPS, University of Barcelona, Barcelona, Spain -

A fraction of third-trimester small fetuses does not achieve their endowed growth potential mainly due to placental insufficiency, usually not evident in terms of impaired umbilical artery Doppler, but severe enough to increase the risk of perinatal adverse outcomes and long-term complications. The identification of those fetuses at higher-risk helps to optimize their follow-up and to decrease the risk of intrauterine demise. Several parameters can help in the identification of those fetuses at higher risk, defined as Fetal Growth Restricted (FGR) fetuses. Read More

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Doppler studies of placental function.

Placenta 2021 Apr 2;108:91-96. Epub 2021 Apr 2.

Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, And Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.

Placental-associated diseases account for most cases of adverse perinatal outcome in developing countries. Doppler evaluation has been incorporated as a predictive parameter at early pregnancy for high-risk placental disease, in the diagnosis and management of those fetuses with impaired intrauterine growth and for the evaluation of fetal wellbeing in those high-risk pregnancies. Uterine Doppler at second trimester predicts most instances of early-onset preeclampsia and intrauterine growth restriction. Read More

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The CErebro Placental RAtio as indicator for delivery following perception of reduced fetal movements, protocol for an international cluster randomised clinical trial; the CEPRA study.

BMC Pregnancy Childbirth 2021 Apr 9;21(1):285. Epub 2021 Apr 9.

Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Background: Routine assessment in (near) term pregnancy is often inaccurate for the identification of fetuses who are mild to moderately compromised due to placental insufficiency and are at risk of adverse outcomes, especially when fetal size is seemingly within normal range for gestational age. Although biometric measurements and cardiotocography are frequently used, it is known that these techniques have low sensitivity and specificity. In clinical practice this diagnostic uncertainty results in considerable 'over treatment' of women with healthy fetuses whilst truly compromised fetuses remain unidentified. Read More

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Comparing the cerebro-placental to umbilico-cerebral Doppler ratios for the prediction of adverse neonatal outcomes in pregnancies complicated by fetal growth restriction.

J Matern Fetal Neonatal Med 2021 Apr 5:1-5. Epub 2021 Apr 5.

Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL, USA.

Objective: The cerebroplacental ratio (CPR) has shown utility as a surrogate marker for fetal growth restriction and can be used to stratify the risk for adverse perinatal outcomes in affected pregnancies. However, recent studies suggest that its inverse, the umbilico-cerebral ratio (UCR), may be a better predictor of such outcomes. The aim of this study was to compare the prognostic accuracy of CPR to that of UCR Doppler in predicting short-term adverse perinatal outcomes in growth-restricted fetuses. Read More

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Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis.

Health Technol Assess 2021 Feb;25(15):1-190

The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Background: Currently, pregnant women are screened using ultrasound to perform gestational aging, typically at around 12 weeks' gestation, and around the middle of pregnancy. Ultrasound scans thereafter are performed for clinical indications only.

Objectives: We sought to assess the case for offering universal late pregnancy ultrasound to all nulliparous women in the UK. Read More

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February 2021

Doppler assessment of the fetus in pregnant women recovered from COVID-19.

J Obstet Gynaecol Res 2021 May 1;47(5):1757-1762. Epub 2021 Mar 1.

University of Health Sciences, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.

Objective: The aim of this study was to evaluate the maternal-fetal Doppler patterns in pregnant women recovered from COVID-19.

Methods: This prospective case-control study was conducted in Ankara City Hospital between July 1, 2020 and August 30, 2020. Thirty pregnant women who were diagnosed with COVID-19 and completed the quarantine process were compared with 40 healthy pregnant women in terms of the fetal Doppler parameters. Read More

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The effect of 75-g oral glucose tolerance test on maternal and foetal Doppler parameters in healthy pregnancies: a cross-sectional observational study.

J Obstet Gynaecol 2021 Jan 15;41(1):83-88. Epub 2021 Feb 15.

Faculty of Medicine, Department of Biostatistics, Istanbul Medeniyet University, Istanbul, Turkey.

Hyperglycaemia can alter placental resistance to blood flow and hyperglycaemia has adverse perinatal outcomes. Oral glucose tolerance testing (OGTT) increases the maternal plasma glucose levels temporarily and mimics metabolic hyperglycaemia. The blood flow of the uterine artery (UtA), umbilical artery (UA), middle cerebral artery (MCA) were assessed before, 1 and 2 h following the OGTT by using Doppler ultrasonography. Read More

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January 2021

The potential association between a new angiogenic marker fractalkine and a placental vascularization in preeclampsia.

Arch Gynecol Obstet 2021 Jan 26. Epub 2021 Jan 26.

Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.

Purpose: Impaired angiogenesis is one of the most common findings in preeclamptic placentas. A new angiogenetic role of fractalkine (CX3CL1) is recently recognized apart from inflammatory activity. In this study, a link between CX3CL1 and the development of placental vasculature in preeclampsia was examined. Read More

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January 2021

The effects of a physical exercise program on fetal well-being and intrauterine safety.

Ginekol Pol 2021 15;92(2):126-131. Epub 2021 Jan 15.

Department of Sport for All, Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education, Warsaw, Poland, Biała Podlaska, Poland.

Objectives: The aim of this study was to evaluate the effects of a supervised physical exercise program on fetal well-being and intrauterine safety. Physical activity is recommended for healthy pregnant women. However, constant evaluation of fetal condition and development is recommended to ensure the safety of the exercise program. Read More

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January 2021

Fetal neurosonography detects differences in cortical development and corpus callosum in late-onset small fetuses.

Ultrasound Obstet Gynecol 2021 Jan 12. Epub 2021 Jan 12.

BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain.

Objective: The aim of this study was to explore whether neurosonography can detect differences in cortical development and corpus callosum length in late-onset small fetuses sub-classified into small-for-gestational age (SGA) or fetal growth restriction (FGR).

Methods: A prospective cohort study in 318 singleton pregnancies including 97 normally grown and 221 late-onset small fetuses (birthweight below the 10 centile diagnosed after 32 weeks of gestation). Small fetuses were sub-classified into SGA (birthweight between the 3 and 9 centile and normal fetoplacental Doppler; n=67) and FGR (birthweight <3 centile and/or abnormal cerebroplacental ratio and/or uterine artery Doppler; n=154). Read More

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January 2021

Study of Association of Fetal Cerebroplacental Ratio with Adverse Perinatal Outcome in Uncomplicated Term AGA Pregnancies.

J Obstet Gynaecol India 2020 Dec 23;70(6):485-489. Epub 2020 Jul 23.

Department of Obst and Gynae, King George Medical University, Lucknow, Uttar Pradesh India.

Background: The cerebroplacental ratio (CPR) is emerging as a predictor for adverse perinatal outcome in term pregnancies. Earlier, it has shown a role in small for gestational age (SGA) pregnancies, but a proportion of appropriate for gestational age foetuses (AGA) despite of good size have impaired growth velocity and are thereby at risk of adverse outcome. CPR has implication for assessment of well being of SGA and AGA foetuses close to term. Read More

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December 2020

Reduced growth velocity from the mid-trimester is associated with placental insufficiency in fetuses born at a normal birthweight.

BMC Med 2020 12 24;18(1):395. Epub 2020 Dec 24.

Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, 163 Studley Road, Heidelberg, VIC, 3084, Australia.

Background: Fetal growth restriction (FGR) due to placental insufficiency is a major risk factor for stillbirth. While small-for-gestational-age (SGA; weight < 10th centile) is a commonly used proxy for FGR, detection of FGR among appropriate-for-gestational-age (AGA; weight ≥ 10th centile) fetuses remains an unmet need in clinical care. We aimed to determine whether reduced antenatal growth velocity from the time of routine mid-trimester ultrasound is associated with antenatal, intrapartum and postnatal indicators of placental insufficiency among term AGA infants. Read More

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December 2020

Maternal cardiac adaptation and fetal growth.

Am J Obstet Gynecol 2020 Dec 24. Epub 2020 Dec 24.

Fetal Medicine Research Institute, King's College Hospital, London, United Kingdom. Electronic address:

Background: Pregnancies with small-for-gestational-age fetuses are at increased risk of adverse maternal-fetal outcomes. Previous studies examining the relationship between maternal hemodynamics and fetal growth were mainly focused on high-risk pregnancies and those with fetuses with extreme birthweights, such as less than the 3rd or 10th percentile and assumed a similar growth pattern in fetuses above the 10th percentile throughout gestation.

Objective: This study aimed to evaluate the trends in maternal cardiac function, fetal growth, and oxygenation with advancing gestational age in a routine obstetrical population and all ranges of birthweight percentiles. Read More

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December 2020

Cerebroplacental ratio as a predictor of intrapartum fetal compromise in term pregnancy.

Int J Gynaecol Obstet 2020 Nov 30. Epub 2020 Nov 30.

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

Objective: To predict intrapartum fetal compromise (FC) and admission to neonatal intensive care unit (NICU) by cerebroplacental ratio (CPR) in term pregnancies.

Methods: A prospective observational study recruited women with singleton, term pregnancies. Ultrasound (US) was done for fetal biometry, umbilical and middle cerebral artery (UA, MCA) Doppler parameters, and CPR calculated. Read More

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November 2020

Modeling gestational age centiles for fetal umbilicocerebral ratio by quantile regression analysis: a secondary analysis of a prospective cross-sectional study.

J Matern Fetal Neonatal Med 2020 Nov 23:1-5. Epub 2020 Nov 23.

Department of Obstetrics and Gynecology, University Hospital of Chieti, Roma, Italy.

Objective: There is a lack of evidence on whether to favor cerebroplacental ratio (CPR) or umbilicocerebral ratio (UCR) when assessing pregnancies at risk of fetal growth restriction. The Recent evidences highlight a significant heterogeneity in the methodology of previously published studies reporting reference ranges for Doppler indices, which may affect the clinical applicability of these charts. The aim of this study was to develop charts of UCR based upon a recently proposed standardized methodology and using quantile regression. Read More

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November 2020

Association between fetoplacental Doppler results, placental pathology, and angiogenic factors among pregnant women with anxiety.

Taiwan J Obstet Gynecol 2020 Nov;59(6):842-847

Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Electronic address:

Objective: This study aimed to evaluate whether state and trait anxiety among pregnant women were associated with fetoplacental Doppler findings, abnormal placental pathology, and placental angiogenic factors.

Materials And Methods: A total of 102 pregnant women at 32-35 gestational weeks were recruited and examined prospectively. State and trait anxiety were measured using the State-Trait Anxiety Inventory. Read More

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November 2020

The added value of umbilical vein flow in predicting fetal macrosomia at 36 weeks of gestation: A prospective cohort study.

Acta Obstet Gynecol Scand 2021 May 21;100(5):900-907. Epub 2021 Jan 21.

Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.

Introduction: Current models based on fetal biometry and maternal characteristics have a poor performance in predicting macrosomia. The primary aim of this study was to elucidate the diagnostic performance of fetal venous and arterial Dopplers in predicting macrosomia in the third trimester of pregnancy; the secondary aim was to build a multiparametric prediction model including pregnancy, ultrasound and Doppler characteristics able to predict macrosomia accurately.

Material And Methods: Prospective cohort study including 2156 singleton pregnancies scheduled for routine ultrasound assessment at 36 weeks of gestation. Read More

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Ten-year experience of protocol-based management of small-for-gestational-age fetuses: perinatal outcome in late-pregnancy cases diagnosed after 32 weeks.

Ultrasound Obstet Gynecol 2021 Jan;57(1):62-69

Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain.

Objective: To report our 10-year experience of protocol-based management of small-for-gestational-age (SGA) fetuses, based on standardized clinical and Doppler criteria, in late-pregnancy cases.

Methods: A retrospective cohort was constructed of consecutive singleton pregnancies referred for late-onset (> 32 weeks) SGA (defined as estimated fetal weight (EFW) < 10 centile) that were classified as fetal growth restriction (FGR) or low-risk SGA, based on the severity of smallness (EFW < 3 centile) and the presence of Doppler abnormalities (uterine artery pulsatility index (UtA-PI) ≥ 95 centile or cerebroplacental ratio (CPR) < 5 centile). Low-risk SGA pregnancies were followed at 2-week intervals and delivered electively at 40 weeks. Read More

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January 2021

The role of abnormal cerebroplacental ratio in predicting adverse fetal outcome in pregnancies with scheduled induction of labor.

Int J Gynaecol Obstet 2021 May 22;153(2):287-293. Epub 2020 Dec 22.

Department of Obstetrics and Gynecology, Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey.

Objective: To investigate the role of abnormal cerebroplacental ratio (CPR) in predicting adverse fetal outcome in pregnancies with induction of labor.

Methods: This prospective observational study conducted at Medeniyet University Göztepe Training and Research Hospital between December 1, 2018 and October 31, 2019 enrolled women with scheduled induction of labor at or beyond 37 weeks of pregnancy. Women with singleton non-anomalous fetuses with cephalic presentation and who had Bishop scores of 5 or less in pelvic examination were included in the study. Read More

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Umbilical and Middle Cerebral Artery Doppler Measurements in Fetuses With Congenital Heart Block.

J Am Soc Echocardiogr 2021 Jan 27;34(1):83-88. Epub 2020 Oct 27.

Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada; Ontario Fetal Centre, Toronto, Canada. Electronic address:

Objectives: In fetal congenital complete heart block, the slow fetal heart rate prolongs the diastolic phase of the cardiac cycle, which may affect Doppler measurements that are typically used to quantify placental function. We here describe the umbilical artery (UA) and middle cerebral artery (MCA) Dopplers in a cohort of fetuses with heart block, hypothesizing that values will be increased but nevertheless remain associated with placental function and fetal outcome.

Methods: We retrospectively reviewed Doppler measurements of the UA and MCA pulsatility index (PI) and resistance index in fetuses with complete heart block. Read More

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January 2021

Fetal cardiac function at 35-37 weeks' gestation in pregnancies that subsequently develop pre-eclampsia.

Ultrasound Obstet Gynecol 2021 Mar 10;57(3):417-422. Epub 2021 Feb 10.

Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK.

Objective: To compare fetal cardiac morphology and function between pregnancies that subsequently developed pre-eclampsia (PE) and those that remained normotensive.

Methods: This was a prospective observational study in 1574 pregnancies at 35-37 weeks' gestation, including 76 that subsequently developed PE. We carried out comprehensive assessment of fetal cardiac morphology and function including novel imaging modalities, such as speckle-tracking echocardiography, and measured uterine artery pulsatility index, mean arterial pressure (MAP), serum placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and cerebroplacental ratio (CPR). Read More

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Influence of birth weight on fetal cardiac indices at 35-37 weeks' gestation.

Ultrasound Obstet Gynecol 2021 Feb 31;57(2):266-272. Epub 2020 Dec 31.

Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK.

Objective: Echocardiographic studies have reported that fetuses with low birth weight, compared to those with normal birth weight, have globular hearts and reduced cardiac function. Dichotomizing continuous variables, such as birth weight, may be helpful in describing pathology in small studies but can prevent us from identifying physiological responses in relation to change in size. The aim of this study was to explore associations between fetal cardiac morphology and function and birth weight, as a continuous variable, as well as uterine artery (UtA) pulsatility index (PI), as an indirect measure of placental perfusion, and the cerebroplacental ratio (CPR), as an indirect measure of fetal oxygenation. Read More

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February 2021

Cerebroplacental ratio as predictor of adverse perinatal outcome in the third trimester.

Acta Obstet Gynecol Scand 2021 03 4;100(3):497-503. Epub 2020 Nov 4.

Obstetrics and Gynecology, Department of Clinical Sciences, Lund University, Lund, Sweden.

Introduction: Fetal growth restriction is associated with adverse perinatal outcome and the clinical management of these pregnancies is a challenge. The aim of this study was to investigate the potential of cerebroplacental ratio (CPR) to predict adverse perinatal outcome in high-risk pregnancies in the third trimester. Another aim was to study whether the CPR has better predictive value than its components, middle cerebral artery (MCA) pulsatility index (PI) and umbilical artery (UA) PI. Read More

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Characterization of Placental Microvascular Architecture by MV-Flow Imaging in Normal and Fetal Growth-Restricted Pregnancies.

J Ultrasound Med 2020 Oct 19. Epub 2020 Oct 19.

Fetal Heart Program, Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Objectives: To observe the microvascular architecture in the placental bed and explore the feasibility and clinical utility of MV-Flow imaging (Samsung Medison Co, Ltd, Seoul, Korea) during normal pregnancy and fetal growth restriction (FGR).

Methods: Placental microvascular structure ultrasound imaging by MV-Flow was performed on 227 unaffected and 17 FGR fetuses between 11 and 41 weeks' gestation. A placental vascular index (VI ) was acquired by application of various MV-Flow regions of interest (ellipse, rectangle, and manual trace). Read More

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October 2020

Inferior Adrenal Artery PI in Fetuses with IUGR: Value Indicating Early Blood Redistribution and Steroidogenic Response.

J Clin Endocrinol Metab 2020 12;105(12)

Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Objective: To characterize the inferior adrenal artery (IAA) pulsatility index (PI) in intrauterine growth-restricted (IUGR) fetuses without brain sparing.

Methods: Twenty-three IUGR fetuses with a normal Doppler cerebroplacental ratio (CPR) and 23 normal controls were included in this prospective cross-sectional study. The PI of the IAA was recorded using routine transabdominal Doppler ultrasound. Read More

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December 2020

The ability of various cerebroplacental ratio thresholds to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction.

J Perinat Med 2021 Feb 7;49(2):209-215. Epub 2020 Sep 7.

Department of Obstetrics and Gynecology, University of Cukurova, Faculty of Medicine, Adana, Turkey.

Objectives: Our primary aim was to evaluate the ability of various cerebroplacental ratio (CPR) reference values suggested by the Fetal Medicine Foundation to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction (LOFGR). Our secondary aim was to evaluate the effectiveness of other obstetric Doppler parameters used to assess fetal well-being in terms of predicting adverse neonatal outcomes.

Methods: This was a retrospective cohort study of 317 pregnant women diagnosed with LOFGR at 37-40 weeks of gestation between January 1, 2016, and September 1, 2019. Read More

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February 2021

Fetal myocardial performance index in pregnancies with idiopathic mildly increased amniotic fluid volume.

J Clin Ultrasound 2021 Feb 11;49(2):117-123. Epub 2020 Aug 11.

Department of Radiology, Faculty of Medicine, Islamic Azad University - Mashhad Branch, Mashhad, Iran.

Purpose: To evaluate modified myocardial performance index (MPI), or Tei index, in fetuses of pregnancies with idiopathic mildly increased amniotic fluid index (AFI).

Methods: We studied 25 cases (24-40 weeks) with idiopathic mildly increased AFI, and 25 gestational age- and fetal gender-matched healthy controls. Fetal echocardiographic variables and Doppler-derived indices were recorded, including left and right MPI, left isovolumetric contraction time (IVCT), left ejection time (ET), left isovolumetric relaxation time (IVRT), aortic and pulmonary arterial peak systolic velocity (PSV), left and right E/A ratios, middle cerebral artery (MCA) pulsatility index (PI), and umbilical artery (UA) PI. Read More

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February 2021

Volume blood flow-based indices of fetal brain sparing in the second half of pregnancy: A longitudinal study.

Acta Obstet Gynecol Scand 2020 12 16;99(12):1717-1727. Epub 2020 Jul 16.

Department of Clinical Science, Division of Obstetrics and Gynecology, Intervention & Technology, Karolinska Institutet and Center for Fetal Medicine Karolinska, University Hospital, Stockholm, Sweden.

Introduction: Cerebroplacental ratio (CPR) and umbilicocerebral ratio (UCR) are clinically used as a measure of fetal brain sparing. These are calculated as the ratios between the pulsatility indices (PIs) of middle cerebral (MCA) and umbilical (UA) arteries, and are an indirect representation of the balance between cerebral and placental perfusion. Volume blood flow (Q)-based ratios, ie Q-CPR or Q-UCR, would directly reflect the distribution of fetal cardiac output to the placenta and brain. Read More

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December 2020

Unfavorable influence of prematurity on the neonatal prognostic of small for gestational age fetuses.

Exp Ther Med 2020 Sep 13;20(3):2415-2422. Epub 2020 May 13.

Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania.

Vascular stress at the level of the uterus-placental unit, with chronic placental ischemia, results in intrauterine growth restriction. Expectation management can be used, when the situation allows, in cases of compensated intrauterine growth restriction. The aim of the present study was to evaluate the neonatal prognosis of preterm births with and without growth restriction and term births with growth restriction in order to improve decisional accuracy regarding the termination of pregnancy. Read More

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September 2020

Comparison between cerebroplacental ratio and umbilicocerebral ratio in predicting adverse perinatal outcome at term.

Eur J Obstet Gynecol Reprod Biol 2020 Sep 24;252:439-443. Epub 2020 Jul 24.

Centre for High Risk Pregnancy and Fetal Care, Department of Obstetrics and Gynecology, University of Chieti, Italy. Electronic address:

Objective: Cerebroplacental ratio (CPR) has been associated with adverse perinatal outcome irrespective of fetal weight. More recently, it has been proposed that the ratio between umbilical and middle cerebral artery pulsatility index, the umbilicocerebral ratio (UCR) had a higher diagnostic accuracy compared to CPR in predicting adverse outcome. The aim of the study was to compare the diagnostic accuracy of CPR and UCR in predicting adverse perinatal outcome in the third trimester of pregnancy. Read More

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September 2020