PREDICTING NEONATAL WELL-BEING IN PREECLAMPSIA: AN IN-DEPTH ANALYSIS OF CEREBROPLACENTAL AND CEREBROUTERINE RATIOS

Abstract

Introduction: High-risk pregnancies are a major health issue worldwide, especially in India, where they cause a lot of perinatal mortality. IUGR, which affects low-birth-weight babies, is a major risk factor. Doppler ultrasound is a cutting-edge technology for monitoring IUGR's complex dynamics. This study examines the complementarity of cerebroplacental (CP) and cerebrouterine (CU) ratios in predicting infant outcomes, using Doppler ultrasound to improve antenatal foetal well-being monitoring and timely intervention in high-risk pregnancies.

Material and Methods: This prospective observational study at a tertiary care centre examined 34–37-week pregnancies with pre-eclampsia from January 2020 to June 2022. It measured the cerebroplacental ratio (CPR) and cerebrouterine ratio using Doppler ultrasound. Labour discomfort and congenital abnormalities were omitted from the 100-person trial. Complete data collection included permission, demographics, and physical exams. Statistics were performed using SPSS V 15.0 and several tests. Informed permission, participant freedom, and secrecy ensured ethics. Krishna Hospital's facilities sponsored the study after Institutional Ethics Committee permission.

Result: The study found incorrect CPR and CUR ratios in 5 of 8 intrauterine deaths (IUDs). In 54 cases, live births had normal ratios. Using both ratios enhanced perinatal outcome prediction sensitivity. A 100-case study found that inadequate CPR and CUR ratios predicted poor outcomes. The findings confirmed that Doppler ratios influence neonatal outcomes. The debate emphasised these ratios' diagnostic relevance, supporting past research. The study stressed the need of integrating Doppler results to predict unfavourable outcomes more accurately.

Conclusion: Overall, standard foetal biometry fails to detect foetal impairment and hemodynamic changes, limiting gestational age and growth information. Doppler ultrasound can measure uterine and umbilical arteries and reveal uteroplacental and fetoplacental circulations. Doppler investigations detect utero-placental insufficiency and acid-base status earlier than other tests due to hemodynamic alterations in response to foetal hypoxemia. The study found that cerebroplacental (CP) and cerebrouterine (CU) ratios are equally accurate, highlighting the sensitivity of combined Doppler results. For quick foetal distress intervention, doppler ultrasonography is essential.