The Role of Umbilicocerebral Ratio and Cerebroplacental Ratio in Predicting Adverse Perinatal Outcomes in Women Undergoing Labor Induction

Abstract

ABSTRACT Purpose To evaluate the predictive value and clinical significance of pre‐induction Doppler blood flow parameters of the umbilical artery (UA) and middle cerebral artery (MCA), as well as cerebroplacental ratio (CPR), and umbilicocerebral ratio (UCR) for fetal distress during labor induction. Methods This prospective study evaluated women at term undergoing labor induction using pre‐induction Doppler ultrasonography. Following the fetal distress diagnostic criteria, they were divided into two groups as the fetal distress group ( n = 225) and the control group ( n = 304) who underwent vaginal delivery. Parameters between the groups were compared; binary logistic regression was applied, and receiver operator characteristic (ROC) curve analysis was performed on the middle cerebral artery flow value. Results In the fetal distress group, the PI values and Z ‐score of the umbilical artery and umbilicocerebral ratio exceeded those in the control group, and the PI values and Z ‐score of the middle cerebral artery and cerebroplacental ratio were lower than those in the control group. An MCA PI cutoff value of 1.44 demonstrated 88.9% sensitivity and 80% specificity for predicting fetal distress. Conclusion Umbilical artery and middle cerebral artery PI values may serve as useful parameters in the assessment of fetal distress.