Middle Cerebral to Umbilical Artery Resistancy in High Risk Pregnancies in the Prediction of Perinatal Outcome

Antenatal fetal surveillance tests have led to a significant decrease in perinatal mortality and morbidity rates especially in high risk pregnancies. There is no concurrence on the best and accurate modality yet. The aim of this study is to evaluate, accuracy of antenatal assessment with biophysical profile and Doppler sonography (cerebral and umbilical artery) regarding fetal acidosis and asphyxia. This is a cross-sectional study on fetus of 70 women with 28-42 weeks singleton pregnancy, which had hypertension, diabetes mellitus or intra uterine growth retardation and were admitted as high risk pregnancies. Study population routinely underwent sonographic evaluation of cerebral and umbilical arteries and biophysical profile twice a week. Infants who had a lower score of biophysical profile, had a lower umbilical Ph and negative base deficit. Fetuses with a lower C/U RI Index had higher base deficit and acidosis (measured from umbilical blood) after birth. Apgar on 5 min was higher in infants with a history of higher profile score, as well as a higher C/U RI Index ratio. On the other hand, there was no significant correlation between MCA RI index or UA RI and Ph or base deficit of umbilical Ph, neither with apgar on 5 min. Biophysical profile and assessment of umbilical and cerebral arteries are valuable modalities for predicting fetus condition and outcome in high risk pregnancies. C/U RI Index ratio is a better indicator compared to its components.