Efficacy of Cerebroplacental Doppler Ratio in Predicting Adverse Fetal Outcomes in Cases of Fetal Growth Restriction Multicenter Study.

Background: Fetal growth restriction (FGR) is a significant cause of perinatal morbidity and mortality. Differentiating FGR from small-for-gestational-age fetuses is critical for risk assessment. This study investigates the cerebroplacental ratio (CPR) as a noninvasive predictor of adverse fetal outcomes, particularly neonatal intensive care unit (NICU) admissions, intrauterine fetal death (IUFD), and birth weight variability.

Methods: This prospective, multicentre study included 60 pregnant women (gestational age 28-34 weeks) divided into normal and abnormal CPR groups. Doppler ultrasonography assessed umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices. Statistical analysis included receiver operating characteristic (ROC) curves for CPR, UA, and MCA indices to predict adverse outcomes.

Results: Abnormal CPR correlated with increased NICU admissions (46.7%), IUFD (10%), and lower birth weight (mean: 2138 g). Elevated UA PI and reduced MCA PI were observed in the abnormal CPR group. Sensitivity and specificity analyses identified CPR (cutoff: 1.1) as a modestly accurate predictor of adverse outcomes.

Conclusions: CPR effectively stratifies risk in high-risk pregnancies but requires further validation. Abnormal Doppler findings highlight placental insufficiency and compromised cerebral perfusion. These findings could refine FGR management strategies.