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The diagnostic value of the cerebroplacental ratio combined with non-stress test for pregnancy outcomes in high-risk pregnancies |
SUN Xihong, LIU Xiaoyan |
Department of Obstetrics and Gynecology,the Sixth Hospital of Shijiazhuang,Shijiazhuang 051000,China |
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Abstract Objective To explore the diagnostic significance of the cerebroplacental ratio(CPR)combined with non-stress test(NST) in high-risk pregnancies.Methods One hundred and twenty high-risk pregnant women who had given birth to singletons at our hospital between December 2018 and February 2020 were chosen as subjects .The average gestational age was 28-41 weeks. Ultrasound was performed to detect the blood flow of the fetal umbilical artery (UA) and middle cerebral artery (MCA), and the CPR was measured. At the same time, prenatal NST was performed. The results of maternal delivery were compared, including amniotic fluid pollution, fetal distress, cesarean section, midwifery (forceps, fetal aspiration). Neonatal outcomes were analyzed, including an Apgar score less than 7 in 1 min, blood gas pH less than 7.25, and admission to NICUs. The effectiveness of different methods of evaluating high-risk pregnancies and adverse pregnancy outcomes was compared, including the sensitivity, specificity, positive predictive value and implicit predictive value.Results According to the results of NSTs and CPRs, these subjects were divided into four groups: group A (normal NST and CRT ), group B (abnormal NST), group C (abnormal CPR), and group D (abnormal NST and CPR). In group D, there were 21 cases of fetal distress (80.77%), 23 cases of amniotic fluid pollution(88.46%), 24 cases of cesarean section(92.31%), 3 cases of assisted delivery (forceps, fetal suction) (11.54%), 17 cases with 1 min Apger score less than 7 points(65.38%), 16 cases with a blood gas pH value less than 7.25(61.54%), and 18 cases admitted to NICUs(69.23%),and the difference was statistically significant compared with the other three groups. The CPR combined with fetal heart rate monitoring had a sensitivity of 97.01%, a specificity of 3.78%, a positive predictive value of 91.06%, and a negative predictive value of 97.27% for predicting adverse pregnancy outcomes, all of which were higher than when the CPR or fetal heart rate monitoring was used alone.Conclusions The combined use of the CPR and NST can facilitate a quick, accurate, safe and valid diagnosis of abnormal conditions in high-risk pregnancies, and can effectively prevent the occurrence of adverse pregnancy outcomes. This approach is of great significance in the management of high-risk pregnancies.
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Received: 13 May 2021
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