Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios

Emre Destegül; Hatice Akkaya; Barış Büke; Güliz Gürer

doi:10.28982/josam.829499

Research Article

Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios

Year 2020, , 1169 - 1172, 01.12.2020

Emre Destegül , Hatice Akkaya , Barış Büke Güliz Gürer

https://doi.org/10.28982/josam.829499

Abstract

Aim: There is conflicting information in the literature regarding perinatal outcomes and management of isolated oligohydramniotic (IO) pregnancies. Recent studies show that IO is associated with poor perinatal outcomes. However, there is still no definitive method for deciding the optimal delivery timing for these patients. In this study, we aimed to assess the relationship between Doppler parameters, especially cerebro-placental ratio, and perinatal outcomes in isolated oligohydramnios (IO) patients.
Methods: This prospective case control study was conducted between October-November 2018. A total of 98 patients were recruited and divided into two groups, as pregnant women with normal amounts of amniotic volume and the isolated oligohydramnios group. Oligohydramnios diagnosis was made by amniotic fluid index measurement (AFI<5 cm). Pregnancies with hypertension, fetal growth restriction, thrombophilia, preeclampsia, diabetes mellitus, preterm births and chromosomal/structural abnormalities were excluded. Cerebro placental ratios of groups were compared in terms of composite adverse outcomes, low APGAR score in 1st and 5th minutes, C/S operation due to non-reassuring fetal heart rate patterns, admission to neonatal intensive care unit and still births.
Results: In the isolated oligohydramnios group (n=45) cerebro-placental ratio (CPR) was lower compared to control group (P<0.001). IO was associated with lower (APGAR score<7) 1st (55.6% vs. 7.5%, P<0.001) and 5th (13.3% vs. 1.9% P=0.028) minute APGAR scores and higher rates of NICU admission (26.7% vs. 3.8% P=0.001). Number of fetal distress cases was higher in patients with low CPR in the IO group (9 vs. 6 P=0.023).
Conclusion: Measurement of CPR among IO patients seems useful for detection of fetuses with higher risk for poor neonatal outcomes.

Keywords

Cerebroplacental ratio, CPR, Isolated Oligohydramnios, Perinatal Outcome, Fetal Doppler

References

1. Hill LM, Breckle R, Wolfgram KR, O’Brien PC. Oligohydramnios: ultrasonically detected incidence and subsequent fetal outcome. Am J Obstet Gynecol. 1983;147:407–10.
2. Mercer LJ, Brown LG, Petres RE, Messer RH. A survey of pregnancies complicated by decreased amniotic fluid. Am J Obstet Gynecol. 1984;149:355–61.
3. Youssef AA, Abdulla SA, Sayed EH, Salem HT, Abdelalim AM, Devoe LD. Superiority of amniotic fluid index over amniotic fluid pocket measurement for predicting bad fetal outcome. South Med J. 1993;86:426–9.
4. Magann EF, Kinsella MJ, Chauhan SP, McNamara MF, Gehring BW, Morrison JC. Does an amniotic fluid index of ≤5 cm necessitate delivery in high-risk pregnancies? A case–control study. Am J Obstet Gynecol. 1999;180:1354–9.
5. Driggers RW, Holcroft CJ, Blakemore KJ, Graham EM. An amniotic fluid index < or =5 cm within 7 days of delivery in the third trimester is not associated with decreasing umbilical arterial pH and base excess. J Perinatol. 2004;24:72–6.
6. Rutherford SE, Phelan JP, Smith CV, Jacobs N. The four-quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353–6.
7. Magann EF, Chauhan SP, Martin JN Jr. Is amniotic fluid volume status predictive of fetal acidosis at delivery? Aust N Z J Obstet Gynaecol. 2003;43:129–33.
8. Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks’ gestation. Am J Obstet Gynecol. 2000;182:909–12.
9. Alchalabi HA, Obeidat BR, Jallad MF, Khader YS. Induction of labor and perinatal outcome: the impact of the amniotic fluid index. Eur J Obstet Gynecol Reprod Biol. 2006;129:124–7.
10. Sultana S, Akbar Khan MN, Khanum Akhtar KA, Aslam M. Low amniotic fluid index in high-risk pregnancy and poor apgar score at birth. J Coll Physicians Surg Pak. 2008;18:630–4.
11. Venturini P, Contu G, Mazza V, Facchinetti F. Induction of labor in women with oligohydramnios. J Matern Fetal Neonatal Med. 2005;17:129–32.
12. Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol. 1999;181:147.
13. Melamed N, Pardo J, Milstein R, Chen R, Hod M, Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011;205:241.e241–241.e246
14. Locatelli A, Vergani P, Toso L, Verderio M, Pezzullo JC, Ghidini A. Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies. Arch Gynecol Obstet. 2004;269:130–3.
15. Rainford M, Adair R, Scialli AR, Ghidini A, Spong CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med. 2001;46:589–92.
16. Conway DL, Adkins WB, Schroeder B, Langer O. Isolated oligohydramnios in the term pregnancy: is it a clinical entity? J Matern Fetal Med. 1998;7:197–200.
17. Ashwal E, Hiersch L, Melamed N, Aviram A, Wiznitzer A, Yogev Y. The association between isolated oligohydramnios at term and pregnancy outcome. Arch Gynecol Obstet. 2014;290:875–81.
18. Bachhav AA, Waikar M. Low amniotic fluid index at term as a predictor of adverse perinatal outcome. J Obstet Gynaecol India. 2014;64:120–3.
19. Rossi Ac, Prefumo F. Perinatal outcomes of isolated oli- gohydramnios at term and post-term pregnancy: a systematic review of literature with meta-analysis. eur J Obstet Gynecol reprod Biol. 2013;169(2):149–54.
20. Zhang J, Troendle J, Meikle S, Klebenoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOC. 2004;111:220–5.
21. Magann EF, Chauhan SP, Dohorty DA, Barrileaux PS, Martin JR. JN. Predictability of intrapartum and neonatal outcomes with the amniotic fluid volume distribution: a reassessment using amniotic fluid index, single deepest pocket, and a dye-determined amniotic fluid volume. Am J Obstet Gynecol. 2003;188(6):1523–7.
22. Chauhan SP, Cowan BD, Magann EF, Roberts WE, Morrison JC, Martin JR. JN. Intrapartum amniotic fluid index. A poor diagnostic test for adverse perinatal outcome. J reprod Med. 1996;41(11):860–6.
23. Chauhan SP, Hendrix NW, Morrison JC, Magann EF, Devore LD. Intrapartum oligohydramnios does not predict adverse peripartum outcome among high risk parturients. Am J Obstet Gynecol. 1997;176(6):1130–6.
24. Rabie N, Mgann E, Steelman Sand S, Ounpraseuth S. Oligohydramnios in complicated and uncomplicated pregnancy: a systematic review and meta-analysis Ultrasound Obstet Gynecol. 2017;49:442–9.
25. Shrem G, Nagawkar SS, Hallak M, Walfisch A. Isolated oligohydramnios at term as an indication for labor induction: a systematic review and meta-analysis. Fetal diagnosis and therapy. 2016;40(3):161-73.
26. Ewigman BG, Crane JP, Frigoletto FD, LeFevre ML, Bain RP, McNellis D et al. Effect of prenatal ultrasound screening on perinatal outcome. New England journal of medicine. 1993;329(12):821-7.
27. American College of Obstetricians and Gynecologists. ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999. Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000;68:175-85.
28. Scwartz N, Sweeting R, Young BK. Practice patterns in the management of isolated oligo- hydramnios: a survey of perinatologists. J Matern Fetal Neonatal Med. 2009;22:357–36.
29. Arbeille P, Roncin A, Berson M, Patat F, Pourcelot L. Exploration of the fetal cerebral blood flow by duplex Doppler—linear array system in normal and pathological pregnancies. Ultrasound Med Biol. 1987;13:329–37.
30. Cruz-Martinez R, Figueras F, Hernandez-Andrade E, Oros D, Gratacos E. Fetal brain Doppler to predict cesarean delivery for non-reassuring fetal status in term 20 small-for- gestational-age fetuses. Obstet Gynecol 2011;117:618-26.
31. Chang TC, Robson SC, Spencer JAD, Gallivan S. Ultrasonic fetal weight estimation: Analysis of inter- and intra-observer variability. J Clin Ultrasound 1993; 21:515–9.
32. Arbeille P, Maulik D, Fignon A, Stale H, Berson M, Bodard S, et al. Assessment of the fetal PO2 changes by cerebral and umbilical Doppler on lamb fetuses during acute hypoxia. Ultrasound Med Biol. 1995;21:861–70.
33. Karahanoglu E, Akpinar F, Demirdag E, Yerebasmaz N, Ensari T, Akyol A, et al. Obstetric outcomes of isolated oligohydramnios during early‐term, full‐term and late‐term periods and determination of optimal timing of delivery. Journal of Obstetrics and Gynaecology Research. 2016;42(9):1119-24.
34. Naveiro-Fuentes M, Prieto AP, Ruíz RS, Badillo MPC, Ventoso FM, Vellejo JLG. Perinatal outcomes with isolated oligohydramnios at term pregnancy. Journal of perinatal medicine. 2016;44(7):793-8.
35. Khalil A, Morales-Rosello J, Khan N, Nath M, Agarwal P, Bhide, A, et al. Is cerebroplacental ratio a marker of impaired fetal growth velocity and adverse pregnancy outcome? American journal of obstetrics and gynecology. 2017;216(6):606-e1.
36. Chainarong N, Petpichetchian C. The relationship between intrapartum cerebroplacental ratio and adverse perinatal outcomes in term fetuses. Eur J Obstet Gynecol Reprod Biol. 2018;228:82–6.
37. Dall’Asta A, Ghi T, Rizzo G, Morganelli G, Galli L, Roletti E, et al. Early labor cerebroplacental ratio assessment in uncomplicated term pregnancies and prediction of adverse perinatal outcomes: a prospective, multicentre study. Ultrasound Obstet Gynecol. 2019;53(4):481-7.
38. Flatley C, Kumar S. Is the fetal cerebroplacental ratio better that the estimated fetal weight in predicting adverse perinatal outcomes in a low risk cohort? J Matern Fetal Neonatal Med. 2019;32(14):2380-6.
39. Fratelli N, Mazzoni G, Maggi C, Gerosa V, Lojacono A, Prefumo F. Cerebroplacental ratio before induction of labour in normally grown fetuses at term and intrapartum fetal compromise. Eur J Obstet Gynecol Reprod Biol 2018;227:78–80.
40. Morales-Roselló J, Khalil A, Fornés-Ferrer V, Perales-Marín A. Accuracy of the fetal cerebroplacental ratio for the detection of intrapartum compromise in nonsmall fetuses. The Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(17):2842-52.
41. Atabay I, Kose S, Cagliyan E, Baysal B, Yücesoy E, Altınyurt S. A prospective cohort study on the prediction of fetal distress and neonatal status with arterial and venous Doppler measurements in appropriately grown term fetuses. Arch Gynecol Obstet. 2017;296:721–30.
42. Bligh LN, Alsolai AA, Greer RM, Kumar S. Cerebroplacental ratio thresholds measured within 2 weeks before birth and risk of Cesarean section for intrapartum fetal compromise and adverse neonatal outcome. Ultrasound Obstet Gynecol. 2018;52(3):340-6.
43. Bligh LN, Alsolai AA, Greer RM, Kumar S. Prelabor screening for intrapartum fetal compromise in low‐risk pregnancies at term: cerebroplacental ratio and placental growth factor. Ultrasound in Obstetrics & Gynecology. 2018;52(6):750-6.
44. Migda M, Gieryn K, Migda B, Migda MS, Maleńczyk M. Utility of Doppler parameters at 36–42 weeks’ gestation in the prediction of adverse perinatal outcomes in appropriate-for-gestational-age fetuses. J Ultrason. 2018;18:22–8.
45. Kalafat E, Khalıl A. Clinical significance of cerebroplacental ratio. Current Opinion in Obstetrics and Gynecology, 2018;30(6):344-54.
46. Ribbert LS, Snijders RJ, Nicolaides KH, Visser GHA. Relationship of fetal biophysical profile and blood gas values at cordocentesis in severely growth-retarded fetuses. Am J Obstet Gynecol. 1990;163:569–71.
47. Vintzileos AM, Fleming AD, Scorza WE, Wolf EJ, Balducci J, Campbell WA, et al. Relationship between fetal biophysical activities and umbilical cord blood gas values. Am J Obstet Gynecol. 1991;165:707–13.

Serebroplasental oranın izole oligohidroamniyoslu hastalarda kötü perinatal sonuçların öngörülmesindeki yeri

Year 2020, , 1169 - 1172, 01.12.2020

Emre Destegül , Hatice Akkaya , Barış Büke Güliz Gürer

https://doi.org/10.28982/josam.829499

Abstract

Amaç: İzole oligohidramniotik (IO) gebeliklerin perinatal sonuçları ve yönetimi ile ilgili literatürde hala çelişkili bilgiler mevcuttur. Son çalışmalarda ise IO’nun kötü perinatal sonuçlar ile ilişkili olduğu yönündedir. Yine de bu hastaların optimal doğum zamanlamasına karar vermek için elimizde hala kesin bir yöntem bulunamamaktadır. Biz de çalışmamızda IO hastalarında Doppler parametreleri, özellikle serebro-plasental oran ve perinatal sonuçlar arasındaki ilişkiyi değerlendirmektir.
Yöntemler: Bu prospektif vaka kontrol çalışması Ekim-Kasım 2018 arasında gerçekleştirildi. Çalışmaya 98 hasta dahil edilmiştir. İzole oligohidroamnios ve normal amnion miktarı olan gebeler grubu olmak üzere iki gruba ayrıldı. Oligohidramnios tanısı amniyotik sıvı indeksi ölçümü ile konuldu (AFI <5 cm). Hipertansiyon, intrauterin büyüme kısıtlılığı, trombofili, preeklampsi, diyabet ve kromozomal / yapısal anormallikleri olan gebelikler çalışma dışı bırakıldı. Gruplar cerebroplasental oran (CPR) ölçümleri göz önüne alınarak; kompozit advers sonuçlar, 1. ve 5. dakikalarda düşük APGAR skoru, güven verici olmayan fetal kalp hızı paternlerine bağlı sezaryen (C/S) operasyonu, yenidoğan yoğun bakım ünitesine yatışı ve ölü doğumlar bakımından karşılaştırıldı.
Bulgular: CPR <1,08 olan hastalarda fetal distress görülme oranı daha yüksekti (9'a karşı 6 P=0,023). İzole oligohidramnios grubunda (n=45) CPR kontrol grubuna göre daha düşük saptandı. Ayrıca IO, daha düşük (APGAR <7) 1. (%55,6 ve %7,5, P<0.001) ve 5. (%13,3 ve %1,9, P=0,028) dakika APGAR skorları ve daha yüksek YYBÜ kabul oranları ile (%26,7 ve %3,8, P=0,001) ilişkili idi.
Sonuç: CPR ölçümü, IO hastalarında kötü neonatal sonuçlar açısından daha yüksek risk taşıyan fetüslerin saptanmasında yararlı görünmektedir.

Keywords

Serebroplasental oran, CPR, İzole oligohidramnios, Perinatal sonuç, Fetal Doppler

References

1. Hill LM, Breckle R, Wolfgram KR, O’Brien PC. Oligohydramnios: ultrasonically detected incidence and subsequent fetal outcome. Am J Obstet Gynecol. 1983;147:407–10.
2. Mercer LJ, Brown LG, Petres RE, Messer RH. A survey of pregnancies complicated by decreased amniotic fluid. Am J Obstet Gynecol. 1984;149:355–61.
3. Youssef AA, Abdulla SA, Sayed EH, Salem HT, Abdelalim AM, Devoe LD. Superiority of amniotic fluid index over amniotic fluid pocket measurement for predicting bad fetal outcome. South Med J. 1993;86:426–9.
4. Magann EF, Kinsella MJ, Chauhan SP, McNamara MF, Gehring BW, Morrison JC. Does an amniotic fluid index of ≤5 cm necessitate delivery in high-risk pregnancies? A case–control study. Am J Obstet Gynecol. 1999;180:1354–9.
5. Driggers RW, Holcroft CJ, Blakemore KJ, Graham EM. An amniotic fluid index < or =5 cm within 7 days of delivery in the third trimester is not associated with decreasing umbilical arterial pH and base excess. J Perinatol. 2004;24:72–6.
6. Rutherford SE, Phelan JP, Smith CV, Jacobs N. The four-quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353–6.
7. Magann EF, Chauhan SP, Martin JN Jr. Is amniotic fluid volume status predictive of fetal acidosis at delivery? Aust N Z J Obstet Gynaecol. 2003;43:129–33.
8. Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks’ gestation. Am J Obstet Gynecol. 2000;182:909–12.
9. Alchalabi HA, Obeidat BR, Jallad MF, Khader YS. Induction of labor and perinatal outcome: the impact of the amniotic fluid index. Eur J Obstet Gynecol Reprod Biol. 2006;129:124–7.
10. Sultana S, Akbar Khan MN, Khanum Akhtar KA, Aslam M. Low amniotic fluid index in high-risk pregnancy and poor apgar score at birth. J Coll Physicians Surg Pak. 2008;18:630–4.
11. Venturini P, Contu G, Mazza V, Facchinetti F. Induction of labor in women with oligohydramnios. J Matern Fetal Neonatal Med. 2005;17:129–32.
12. Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol. 1999;181:147.
13. Melamed N, Pardo J, Milstein R, Chen R, Hod M, Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011;205:241.e241–241.e246
14. Locatelli A, Vergani P, Toso L, Verderio M, Pezzullo JC, Ghidini A. Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies. Arch Gynecol Obstet. 2004;269:130–3.
15. Rainford M, Adair R, Scialli AR, Ghidini A, Spong CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med. 2001;46:589–92.
16. Conway DL, Adkins WB, Schroeder B, Langer O. Isolated oligohydramnios in the term pregnancy: is it a clinical entity? J Matern Fetal Med. 1998;7:197–200.
17. Ashwal E, Hiersch L, Melamed N, Aviram A, Wiznitzer A, Yogev Y. The association between isolated oligohydramnios at term and pregnancy outcome. Arch Gynecol Obstet. 2014;290:875–81.
18. Bachhav AA, Waikar M. Low amniotic fluid index at term as a predictor of adverse perinatal outcome. J Obstet Gynaecol India. 2014;64:120–3.
19. Rossi Ac, Prefumo F. Perinatal outcomes of isolated oli- gohydramnios at term and post-term pregnancy: a systematic review of literature with meta-analysis. eur J Obstet Gynecol reprod Biol. 2013;169(2):149–54.
20. Zhang J, Troendle J, Meikle S, Klebenoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOC. 2004;111:220–5.
21. Magann EF, Chauhan SP, Dohorty DA, Barrileaux PS, Martin JR. JN. Predictability of intrapartum and neonatal outcomes with the amniotic fluid volume distribution: a reassessment using amniotic fluid index, single deepest pocket, and a dye-determined amniotic fluid volume. Am J Obstet Gynecol. 2003;188(6):1523–7.
22. Chauhan SP, Cowan BD, Magann EF, Roberts WE, Morrison JC, Martin JR. JN. Intrapartum amniotic fluid index. A poor diagnostic test for adverse perinatal outcome. J reprod Med. 1996;41(11):860–6.
23. Chauhan SP, Hendrix NW, Morrison JC, Magann EF, Devore LD. Intrapartum oligohydramnios does not predict adverse peripartum outcome among high risk parturients. Am J Obstet Gynecol. 1997;176(6):1130–6.
24. Rabie N, Mgann E, Steelman Sand S, Ounpraseuth S. Oligohydramnios in complicated and uncomplicated pregnancy: a systematic review and meta-analysis Ultrasound Obstet Gynecol. 2017;49:442–9.
25. Shrem G, Nagawkar SS, Hallak M, Walfisch A. Isolated oligohydramnios at term as an indication for labor induction: a systematic review and meta-analysis. Fetal diagnosis and therapy. 2016;40(3):161-73.
26. Ewigman BG, Crane JP, Frigoletto FD, LeFevre ML, Bain RP, McNellis D et al. Effect of prenatal ultrasound screening on perinatal outcome. New England journal of medicine. 1993;329(12):821-7.
27. American College of Obstetricians and Gynecologists. ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999. Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000;68:175-85.
28. Scwartz N, Sweeting R, Young BK. Practice patterns in the management of isolated oligo- hydramnios: a survey of perinatologists. J Matern Fetal Neonatal Med. 2009;22:357–36.
29. Arbeille P, Roncin A, Berson M, Patat F, Pourcelot L. Exploration of the fetal cerebral blood flow by duplex Doppler—linear array system in normal and pathological pregnancies. Ultrasound Med Biol. 1987;13:329–37.
30. Cruz-Martinez R, Figueras F, Hernandez-Andrade E, Oros D, Gratacos E. Fetal brain Doppler to predict cesarean delivery for non-reassuring fetal status in term 20 small-for- gestational-age fetuses. Obstet Gynecol 2011;117:618-26.
31. Chang TC, Robson SC, Spencer JAD, Gallivan S. Ultrasonic fetal weight estimation: Analysis of inter- and intra-observer variability. J Clin Ultrasound 1993; 21:515–9.
32. Arbeille P, Maulik D, Fignon A, Stale H, Berson M, Bodard S, et al. Assessment of the fetal PO2 changes by cerebral and umbilical Doppler on lamb fetuses during acute hypoxia. Ultrasound Med Biol. 1995;21:861–70.
33. Karahanoglu E, Akpinar F, Demirdag E, Yerebasmaz N, Ensari T, Akyol A, et al. Obstetric outcomes of isolated oligohydramnios during early‐term, full‐term and late‐term periods and determination of optimal timing of delivery. Journal of Obstetrics and Gynaecology Research. 2016;42(9):1119-24.
34. Naveiro-Fuentes M, Prieto AP, Ruíz RS, Badillo MPC, Ventoso FM, Vellejo JLG. Perinatal outcomes with isolated oligohydramnios at term pregnancy. Journal of perinatal medicine. 2016;44(7):793-8.
35. Khalil A, Morales-Rosello J, Khan N, Nath M, Agarwal P, Bhide, A, et al. Is cerebroplacental ratio a marker of impaired fetal growth velocity and adverse pregnancy outcome? American journal of obstetrics and gynecology. 2017;216(6):606-e1.
36. Chainarong N, Petpichetchian C. The relationship between intrapartum cerebroplacental ratio and adverse perinatal outcomes in term fetuses. Eur J Obstet Gynecol Reprod Biol. 2018;228:82–6.
37. Dall’Asta A, Ghi T, Rizzo G, Morganelli G, Galli L, Roletti E, et al. Early labor cerebroplacental ratio assessment in uncomplicated term pregnancies and prediction of adverse perinatal outcomes: a prospective, multicentre study. Ultrasound Obstet Gynecol. 2019;53(4):481-7.
38. Flatley C, Kumar S. Is the fetal cerebroplacental ratio better that the estimated fetal weight in predicting adverse perinatal outcomes in a low risk cohort? J Matern Fetal Neonatal Med. 2019;32(14):2380-6.
39. Fratelli N, Mazzoni G, Maggi C, Gerosa V, Lojacono A, Prefumo F. Cerebroplacental ratio before induction of labour in normally grown fetuses at term and intrapartum fetal compromise. Eur J Obstet Gynecol Reprod Biol 2018;227:78–80.
40. Morales-Roselló J, Khalil A, Fornés-Ferrer V, Perales-Marín A. Accuracy of the fetal cerebroplacental ratio for the detection of intrapartum compromise in nonsmall fetuses. The Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(17):2842-52.
41. Atabay I, Kose S, Cagliyan E, Baysal B, Yücesoy E, Altınyurt S. A prospective cohort study on the prediction of fetal distress and neonatal status with arterial and venous Doppler measurements in appropriately grown term fetuses. Arch Gynecol Obstet. 2017;296:721–30.
42. Bligh LN, Alsolai AA, Greer RM, Kumar S. Cerebroplacental ratio thresholds measured within 2 weeks before birth and risk of Cesarean section for intrapartum fetal compromise and adverse neonatal outcome. Ultrasound Obstet Gynecol. 2018;52(3):340-6.
43. Bligh LN, Alsolai AA, Greer RM, Kumar S. Prelabor screening for intrapartum fetal compromise in low‐risk pregnancies at term: cerebroplacental ratio and placental growth factor. Ultrasound in Obstetrics & Gynecology. 2018;52(6):750-6.
44. Migda M, Gieryn K, Migda B, Migda MS, Maleńczyk M. Utility of Doppler parameters at 36–42 weeks’ gestation in the prediction of adverse perinatal outcomes in appropriate-for-gestational-age fetuses. J Ultrason. 2018;18:22–8.
45. Kalafat E, Khalıl A. Clinical significance of cerebroplacental ratio. Current Opinion in Obstetrics and Gynecology, 2018;30(6):344-54.
46. Ribbert LS, Snijders RJ, Nicolaides KH, Visser GHA. Relationship of fetal biophysical profile and blood gas values at cordocentesis in severely growth-retarded fetuses. Am J Obstet Gynecol. 1990;163:569–71.
47. Vintzileos AM, Fleming AD, Scorza WE, Wolf EJ, Balducci J, Campbell WA, et al. Relationship between fetal biophysical activities and umbilical cord blood gas values. Am J Obstet Gynecol. 1991;165:707–13.

There are 47 citations in total.

Details

Primary Language	English
Subjects	Obstetrics and Gynaecology
Journal Section	Research article
Authors	Emre Destegül 0000-0001-5726-0223 Hatice Akkaya 0000-0002-9613-1712 Barış Büke This is me 0000-0001-8761-2023 Güliz Gürer This is me 0000-0003-2922-430X
Publication Date	December 1, 2020
Published in Issue	Year 2020

Cite

APA	Destegül, E., Akkaya, H., Büke, B., Gürer, G. (2020). Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios. Journal of Surgery and Medicine, 4(12), 1169-1172. https://doi.org/10.28982/josam.829499
AMA	Destegül E, Akkaya H, Büke B, Gürer G. Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios. J Surg Med. December 2020;4(12):1169-1172. doi:10.28982/josam.829499
Chicago	Destegül, Emre, Hatice Akkaya, Barış Büke, and Güliz Gürer. “Evaluation of Cerebroplacental Ratio As a New Tool to Predict Adverse Perinatal Outcomes in Patients With Isolated Oligohydramnios”. Journal of Surgery and Medicine 4, no. 12 (December 2020): 1169-72. https://doi.org/10.28982/josam.829499.
EndNote	Destegül E, Akkaya H, Büke B, Gürer G (December 1, 2020) Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios. Journal of Surgery and Medicine 4 12 1169–1172.
IEEE	E. Destegül, H. Akkaya, B. Büke, and G. Gürer, “Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios”, J Surg Med, vol. 4, no. 12, pp. 1169–1172, 2020, doi: 10.28982/josam.829499.
ISNAD	Destegül, Emre et al. “Evaluation of Cerebroplacental Ratio As a New Tool to Predict Adverse Perinatal Outcomes in Patients With Isolated Oligohydramnios”. Journal of Surgery and Medicine 4/12 (December 2020), 1169-1172. https://doi.org/10.28982/josam.829499.
JAMA	Destegül E, Akkaya H, Büke B, Gürer G. Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios. J Surg Med. 2020;4:1169–1172.
MLA	Destegül, Emre et al. “Evaluation of Cerebroplacental Ratio As a New Tool to Predict Adverse Perinatal Outcomes in Patients With Isolated Oligohydramnios”. Journal of Surgery and Medicine, vol. 4, no. 12, 2020, pp. 1169-72, doi:10.28982/josam.829499.
Vancouver	Destegül E, Akkaya H, Büke B, Gürer G. Evaluation of cerebroplacental ratio as a new tool to predict adverse perinatal outcomes in patients with isolated oligohydramnios. J Surg Med. 2020;4(12):1169-72.

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