Review: Systematic review of the utility of the fetal cerebroplacental ratio measured at term for the prediction of adverse perinatal outcome

Dunn, Liam, Sherrell, Helen and Kumar, Sailesh (2017) Review: Systematic review of the utility of the fetal cerebroplacental ratio measured at term for the prediction of adverse perinatal outcome. Placenta, 54 68-75. doi:10.1016/j.placenta.2017.02.006


Author Dunn, Liam
Sherrell, Helen
Kumar, Sailesh
Title Review: Systematic review of the utility of the fetal cerebroplacental ratio measured at term for the prediction of adverse perinatal outcome
Journal name Placenta   Check publisher's open access policy
ISSN 1532-3102
0143-4004
Publication date 2017-02-12
Sub-type Article (original research)
DOI 10.1016/j.placenta.2017.02.006
Open Access Status Not yet assessed
Volume 54
Start page 68
End page 75
Total pages 8
Place of publication London, United Kingdom
Publisher Elsevier
Collection year 2018
Language eng
Formatted abstract
Aim: This systematic review evaluates the utility of the fetal cerebroplacental ratio (CPR) when assessed at term (from 37 + 0 weeks gestation) as a predictor of adverse obstetric and perinatal outcomes.

Data sources and search strategy: An electronic search of Pubmed and Embase using variations of 'cerebroplacental ratio' and 'cerebroumbilical ratio' was conducted by two independent reviewers. Full text studies written in English that reported on low CPR and its correlation with relevant obstetric and perinatal outcomes were included.

Results: Twenty one studies satisfied inclusion with 13 prospective and eight retrospective analyses. Fetal CPR was predictive of caesarean section for intrapartum fetal compromise, small for gestational age and fetal growth restriction and neonatal intensive care unit admission. Low CPR was also significantly associated with abnormal fetal heart rate pattern, meconium stained liquor, low Apgar score, acidosis at birth and composite adverse perinatal outcome scores. The CPR when taken at term had comparable if not better predictive value than that when taken at pre-term. Most studies included small for gestational age fetuses and postdate pregnancies. Subtle variation existed in the threshold for low CPR.

Conclusion: The CPR at term has a strong association with adverse obstetric and perinatal outcomes. This review suggests the predictive utility of CPR at term is promising however there is insufficient evidence to demonstrate its value as a stand-alone test. Inclusion of CPR as a component of clinical care may help better identify fetuses at risk of adverse outcome, and this should be tested with randomised control trials.
Keyword Cerebroplacental ratio
Dopplers
Perinatal outcomes
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
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School of Medicine Publications
 
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