Fetuses with cerebral blood flow redistribution are susceptible to adverse perinatal outcomes

Key clinical point: Fetal cerebral blood flow redistribution assessed by antenatal Doppler scanning is a strong and independent indicator of a composite adverse perinatal outcome (CAPO) and stillbirth in low-resource settings.

Main finding: Middle cerebral artery pulsatility index (PI) <5^th percentile (adjusted odds ratio [aOR] 2.08; P = .013), cerebroplacental ratio (CPR) <5^th percentile (aOR 2.22; P = .02), and uterine artery PI >95^th percentile (aOR 2.36; P = .041) showed a significant association with CAPO. CPR <5^th percentile was significantly associated with stillbirth (aOR 4.82; P = .038).

Study details: Findings are from a single-center prospective cohort study including 995 singleton pregnant women who enrolled in antenatal care after <24 weeks of pregnancy and showed no obvious fetal abnormalities on an antenatal ultrasound scan.

Disclosures: The study was sponsored by Grand Challenges Canada and University Medical Center Utrecht, The Netherlands. No conflict of interests was reported.

Source: Ali S et al. BJOG. 2022 (Feb 4). Doi: 10.1111/1471-0528.17115.

Key clinical point: Fetal cerebral blood flow redistribution assessed by antenatal Doppler scanning is a strong and independent indicator of a composite adverse perinatal outcome (CAPO) and stillbirth in low-resource settings.

Main finding: Middle cerebral artery pulsatility index (PI) <5^th percentile (adjusted odds ratio [aOR] 2.08; P = .013), cerebroplacental ratio (CPR) <5^th percentile (aOR 2.22; P = .02), and uterine artery PI >95^th percentile (aOR 2.36; P = .041) showed a significant association with CAPO. CPR <5^th percentile was significantly associated with stillbirth (aOR 4.82; P = .038).

Study details: Findings are from a single-center prospective cohort study including 995 singleton pregnant women who enrolled in antenatal care after <24 weeks of pregnancy and showed no obvious fetal abnormalities on an antenatal ultrasound scan.

Disclosures: The study was sponsored by Grand Challenges Canada and University Medical Center Utrecht, The Netherlands. No conflict of interests was reported.

Source: Ali S et al. BJOG. 2022 (Feb 4). Doi: 10.1111/1471-0528.17115.

Key clinical point: Fetal cerebral blood flow redistribution assessed by antenatal Doppler scanning is a strong and independent indicator of a composite adverse perinatal outcome (CAPO) and stillbirth in low-resource settings.

Main finding: Middle cerebral artery pulsatility index (PI) <5^th percentile (adjusted odds ratio [aOR] 2.08; P = .013), cerebroplacental ratio (CPR) <5^th percentile (aOR 2.22; P = .02), and uterine artery PI >95^th percentile (aOR 2.36; P = .041) showed a significant association with CAPO. CPR <5^th percentile was significantly associated with stillbirth (aOR 4.82; P = .038).

Study details: Findings are from a single-center prospective cohort study including 995 singleton pregnant women who enrolled in antenatal care after <24 weeks of pregnancy and showed no obvious fetal abnormalities on an antenatal ultrasound scan.

Disclosures: The study was sponsored by Grand Challenges Canada and University Medical Center Utrecht, The Netherlands. No conflict of interests was reported.

Source: Ali S et al. BJOG. 2022 (Feb 4). Doi: 10.1111/1471-0528.17115.