Prognostic Value of Umbilicocerebral and Cerebroplacental Ratios inLate-Onset Fetal Growth Restriction: A Prospective Observational Study

Introduction/Objectives: Fetal growth restriction (FGR) is a significant obstetric concern due to its association with adverse perinatal outcomes. This study aims to compare the prognostic utility of the umbilicocerebral ratio (UCR) and cerebroplacental ratio (CPR) in predicting adverse outcomes in pregnancies complicated by late-onset FGR. Method: This prospective observational study was conducted over 18 months at a tertiary care center. Antenatal women between 32 and 40 weeks of gestation diagnosed with late-onset FGR were included. Pulsatility indices (PI) of the fetal middle cerebral artery and umbilical artery were obtained via Doppler ultrasound to calculate CPR and UCR. Thresholds used were CPR ≤1.76 and UCR ≥1. Patients were followed until delivery, and perinatal outcomes were analyzed. Results: Of the 75 women enrolled, abnormal CPR was present in 58 (77.3%) and abnormal UCR in 31 (41.3%). Adverse perinatal outcomes were significantly more frequent among those with abnormal CPR and UCR, including NICU admission, preterm birth, and perinatal mortality. Discussion: The present study suggests integrating CPR and UCR together into routine Doppler surveillance of pregnancies with suspected FGR, especially in late gestation. An abnormal CPR should prompt close monitoring and possibly early delivery planning to prevent stillbirths or NICU admissions. Elevated UCR, given its correlation with low Apgar and perinatal death, may serve as an early warning for escalating fetal compromise. Conclusión: CPR and UCR are valuable tools for monitoring pregnancies complicated by lateonset FGR. Used together, they enhance the prediction of adverse perinatal outcomes, allowing timely and targeted clinical interventions.