DOI: 10.36347/sjams.2019.v07i01.019

Pages: 109-114

Objectives: To calculate the normal range for the fetal middle cerebral artery (MCA)/uterine artery pulsatility index (PI) ratio in the third trimester of pregnancy and to assess its value in predicting an unfavorable outcome of pregnancies complicated by pre-eclampsia. Doppler blood flow velocimetry of the uterine and fetal MCA was performed. We calculated the ratios between the PI of the MCA and the mean PI value of both uterine arteries. All women were examined at or beyond 30 weeks of gestation. An observational study of 110 with HDP were assessed prospectively and the results were related to perinatal outcome. Normal MCA/uterine artery PI ratios decreased with advancing gestational age. In our study we have found that CU ratio can be used to predict neonatal death (p-value = 0.024) in a significant way. Abnormal CU ratio has been associated with SGA babies in 50% cases and preterm births in 62.50% cases. Low 5 min APGAR, NICU admission and caesarean section as the mode of delivery has been seen in 75% cases with abnormal CU ratio. CU ratio has shown to have a very high specificity. The specificity came out to be 92.31% for SGA babies, 95.65% for low 5 min APGAR score, 96% for NICU admission, 94.44% for preterm babies, 92% for LSCS as mode of delivery and 95% for neonatal deaths. The accuracy of CU ratio for predicting adverse perinatal outcome is highest for neonatal death i.e. 89.09%. CU ratio therefore can be considered as the single best predictor of neonatal death with specificity and PPV of 95% and 89.09% respectively. Abnormally low MCA/ uterine artery PI ratios are related to unfavorable pregnancy outcome. The result of this study supports the use of CU ratio as an important antenatal fetal surveillance parameter in the diagnosis of the complications of hypertensive disorders of pregnancy. CU ratio, along with active intervention and best nursery care facilities, can be used to improve the fetal salvage and reduce perinatal morbidity and mortality in th