title: Predictive value of middle cerebral artery to uterine artery pulsatility index ratio in hypertensive disorders of pregnancy.
abstract: Aims and Objectives. (i) To determine the predictive value of cerebrouterine (CU) ratio (middle cerebral artery to uterine artery pulsatility index, MCA/UT PI) in assessing perinatal outcome among hypertensive disorders of pregnancy. (ii) To compare between CU ratio and CP ratio (MCA/Umbilical artery PI) as a predictor of adverse perinatal outcome. Methods. A prospective observational study was done in a tertiary medical college hospital, from September 2012 to August 2013. One hundred singleton pregnancies complicated by hypertension peculiar to pregnancy were enrolled. Both CU and CP ratios were estimated. The perinatal outcomes were studied. Results. Both cerebrouterine and cerebroplacental ratios had a better negative predictive value in predicting adverse perinatal outcome. However, both CU and CP ratios when applied together were able to predict adverse outcomes better than individual ratios. The sensitivity, specificity, positive predictive value, and the negative predictive values for an adverse neonatal outcome with CU ratio were 61.3%, 70.3%, 56%, and 78.9%, respectively, compared to 42%, 57.5%, 62%, and 76% as with CP ratio. Conclusion. Cerebrouterine ratio and cerebroplacental ratio were complementary to each other in predicting the adverse perinatal outcomes. Individually, both ratios were reassuring for favorable perinatal outcome with high negative predictive value.
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, India.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Adiga
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, India.
authors.forename: Indumathi
authors.initials: I
authors.lastname: Kantharaja
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, India.
authors.forename: Shripad
authors.initials: S
authors.lastname: Hebbar
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, India.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Rai
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, India.
authors.forename: Shyamala
authors.initials: S
authors.lastname: Guruvare
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Mundkur