Diagnostic Accuracy of Cerebroplacental Ratio in Prediction of Postnatal Outcomes in Oligohydramnios

Huma Mahmood Mughal; Mahjabeen Mahmood Kamal; Hammad Ayaz; Muhammad Wasim Awan; Naila Nasir Usmani; Shaghaf Iqbal; Maham Bilal; Abu Bakar Niazi; Hassan Mumtaz

doi:10.7759/cureus.33131

Diagnostic Accuracy of Cerebroplacental Ratio in Prediction of Postnatal Outcomes in Oligohydramnios

Cureus. 2022 Dec 30;14(12):e33131. doi: 10.7759/cureus.33131. eCollection 2022 Dec.

Authors

Affiliations

¹ Radiology, Khan Research Laboratories (KRL) Hospital, Islamabad, PAK.
² Diagnostic Radiology, Khan Research Laboratories (KRL) Hospital, Islamabad, PAK.
³ Radiology, Shifa International Hospital, Islamabad, PAK.
⁴ Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.
⁵ Medicine, Mayo Hospital, Lahore, PAK.
⁶ Urology, Guy's and St. Thomas' Hospital, London, GBR.
⁷ General Practice, Surrey Docks Health Centre, London, GBR.
⁸ Public Health, Health Services Academy, Islamabad, PAK.
⁹ Clinical Research Center, Maroof International Hospital, Islamabad, PAK.

Abstract

Background and aim: The evidence on isolated oligohydramnios (IO) patients and their postnatal outcomes are inconsistent. Recent research has clarified the connection between that IO and negative outcomes in the postnatal period. Our goal was to analyze the correlation between Doppler measurements and postnatal outcomes in oligohydramnios patients, with a focus on the cerebroplacental ratio (CPR).

Methodology: A cohort study was conducted in the Radiology Department of Khan Research Laboratories (KRL) Hospital from October 2021 to July 2022. One hundred women were chosen as the sample size. For this study, we used the Raosoft sample size calculator with a 95% confidence interval and a 5% margin of error. Both the middle cerebral artery and the umbilical artery were imaged using ultrasound, and the systolic-to-diastolic ratio and peak systolic velocity are recorded. Pulsatility index (PI) and resistive index (RI) were also calculated. If the amniotic fluid index (AFI) is less than 5 cm, the condition is known as oligohydramnios. The newborn's APGAR score was taken immediately after birth as well as after 5 minutes.

Results: We have determined that, on average, mothers are 35.45 weeks/248.15 days pregnant. When compared to the reference standard, CPR diagnostic features showed a sensitivity of 92% and a specificity of 77.27. Overall diagnostic accuracy is predicted to be 93.0%, with a 93.50% positive prognosis and a 73.91% negative prognosis. The effect size for the change in APGAR scores before and after the test was -2.38 1.03, with a 95% confidence interval of -2.58 to -2.17 and a significance level of 0.00.

Conclusion: This study concludes that CPR is an effective screening tool and that it can be used to predict postnatal outcomes in patients with oligohydramnios. Clinical prediction rules were found to be a more effective screening tool, with a sensitivity of 92%, a specificity of 77.27%, and a diagnostic accuracy of 92.3%.

Keywords: cerebroplacental ratio; cpr; fetal doppler; isolated oligohydramnios; postnatal outcome.