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17.07.2019 | Original Article | Ausgabe 6/2019

The Journal of Obstetrics and Gynecology of India 6/2019

Association Between Fetal Middle Cerebral Artery and Umbilical Artery Doppler Ratio with Fetal Distress in 38–40 Weeks of Gestation

Zeitschrift:
The Journal of Obstetrics and Gynecology of India > Ausgabe 6/2019
Autoren:
Sara Masihi, Roshan Nikbakht, Mojgan Barati, Mohammad Momen Gharibvand, Azam Jadidi
Wichtige Hinweise
Sara Masihi is a Associated Professor in Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences. Roshan Nikbakht is a Associated Professor in Fertility Infertility and Prinatology Research Center, Ahvaz Jundishapur University of Medical Sciences. Mojgan Barati is a Associated Professor in Fertility Infertility and Prinatology Research Center, Ahvaz Jundishapur University of Medical Sciences. Mohammad Momen Gharibvand is a Associated Professor, Radiologist and Sonologist, Ahvaz Jundishapur University of Medical Sciences. Azam Jadidi is Resident Assistant Professor in Ahvaz Jundishapur University of Medical Sciences.

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Abstract

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 and umbilical artery Doppler ratio with fetal distress at 38–40 weeks of gestation.

Materials and Methods

In this prospective cohort, 181 consecutive pregnant women with 38–40 weeks of gestational age were selected by a non-random convenience sampling method 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, and the association of this ratio with fetal distress consequently was assessed as well.

Results

In this study, abnormal amniotic fluid index (AFI) (1.1%), low birth weight (< 2500 g) (5.5%), emergency cesarean (11.6%), neonatal intensive care unit (NICU) admission (12.2%), low 5th minute Apgar (< 7) (0.6%), abnormal fetal monitoring (10.5%), fetal distress (11.6%), meconium aspiration syndrome (10.5%), and respiratory distress (3.9%) were present. The mean cerebroplacental ratio was 1.9. There was a significant association between low fetal middle cerebral artery pulsatility index and 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, and negative predictive value of 80.95, 50, 17.5, and 95.2%, respectively.

Conclusion

It may be concluded that in our study a cutoff for fetal middle cerebral artery to umbilical artery ratio of 1.94 at 38 weeks was considered statistically significant in predicting fetal distress at 38–40 weeks. However, further studies with larger sample size and multi-center sampling would develop more definite results for wider application.

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