A Prospective Analysis of the Association Between Antepartum Cerebroplacental Ratio and Risk of Adverse Fetal Outcomes in Full-Term Pregnancies at Tertiary Care Setting, Sahiwal, Pakistan

Objective: To evaluate the association of cerebroplacental ratio, Doppler ultrasound, and risk of adverse fetaloutcomes in normal-term pregnancies.Study Design: A prospective cohort study.Place and Duration of Study: This study was conducted at the Department of Gynecology and Obstetrics andRadiology, Sahiwal Medical College and Teaching Hospital, Sahiwal, Pakistan from 1st April 2024 to 30th March2025.Methods: A total of 250 pregnant women with singleton pregnancies and gestation age between 37 and 41weeks, admitted to the hospital during latent labor, were included in the study. The cerebroplacental ratio wascalculated as the middle cerebral artery pulsatility index divided by the umbilical cord pulsatility index. Allmeasurements were classified by gestational age percentile into specific groups. Adverse fetal outcomesincluded fetal death, meconium-stained amniotic fluid, Apgar score <7 at 5 minutes, stillbirth, NICU admission,and need for ventilator, sepsis, hypothermia, non-invasive ventilation, hypoglycemia, and necrotizingenterocolitis.Results: The incidence of abnormal heart rate was higher in fetuses with cerebroplacental ratio (CPR) <5thpercentile in comparison with CPR >5th percentile (54.5% vs 30%). Similar results were recorded in both groupswith CPR <1 (60% vs 30%, P=0.04). A cerebroplacental ratio (CPR) <5th percentile had a positive predictive valueof 24% and a negative predictive value of 90% for abnormal fetal heart rate. However, the positive predictivevalue of cerebroplacental ratio (CPR)<1 and 1.08 for both parameters was 5% and 7%, respectively. Thecerebroplacental ratio (CPR) >95th percentile had a negative predictive value of 98% and 99%, respectively.Conclusion: A low cerebroplacental ratio is a predictor of fetal distress requiring operative delivery andabnormal fetal heart rate, with low positive predictive value and high negative predictive value. Acerebroplacental ratio (CPR) <5th percentile, however, was only correlated to abnormal fetal heart rate. How to cite this: Jamal Y, Shaukat M, Irum R. A Prospective Analysis of the Association Between Antepartum Cerebroplacental Ratio and Risk of Adverse Fetal Outcomes in Full-Term Pregnancies at Tertiary Care Setting, Sahiwal, Pakistan. Life and Science. 2025; 6(4): 547-552. doi: http://doi.org/10.37185/LnS.1.1.943