Middle cerebral artery to umbilical artery resistance index ratio in the prediction of neonatal outcome

Objective: The objectives of this study were to evaluate the usefulness of the middle cerebral artery to umbilical artery resistance index ratio (C/U ratio) as a predictor of adverse perinatal outcome, and to show that the ab sence of fetal umbilical artery end-diastolic velocity (AEDV) in SGA fetuse s is associated with high morbidity and mortality. Method: In this prospect ive study, color Doppler flow imaging was used for the estimation of the C/ U ratio in fetuses that were small for their gestational age, in 70 singlet on pregnancies between 29 and 42 weeks of gestation. The subjects were cate gorized into two groups, with Group A consisting of 35 small for gestationa l age (SGA) fetuses with a normal C/U ratio (1.05 or higher), and Group B c omprising 35 SGA fetuses with an abnormal C/U ratio (below 1.05). Result: T he mean C/U ratio values for birth weight and gestational age were higher i n group A than in group B. Fetuses born to mothers in group B stayed longer in the neonatal special care unit (NSCU), whereas the period from ultrasou nd examination to delivery was higher in the cases in group A. A higher per centage of mothers with an abnormal C/U ratio underwent cesarean section. F etuses with an absent end-diastolic velocity of the umbilical artery had a higher morbidity. Three stillbirths occurred in fetuses with an absent end- diastolic velocity of the umbilical artery. Conclusion: Our results suggest that the C/U ratio is a good predictor of neonatal outcome, and could be u sed to identify fetuses at risk of morbidity and mortality. Fetal umbilical artery AEDV with intrauterine growth restriction is associated with high p erinatal morbidity and mortality. (C) 2000 International Federation of Gyne cology and Obstetrics. All rights reserved.