European Journal of Cardiovascular Medicine

Introduction- Doppler is a noninvasive method for evaluation of fetoplacental circulation without any disturbance to human pregnancy. It gives valuable information about hemodynamic situation of the fetus and is an efficient diagnostic test of fetal jeopardy that helps in management of high-risk pregnancy. Doppler ultrasound technology evaluates umbilical artery (and other fetal arteries) waveforms to assess fetal well-being in the third trimester of pregnancy. Aims and objectives- To evaluate the usefulness of the pulsatility index (PI) of the umbilical artery (UA) and the pulsatility index of fetal middle cerebral artery (MCA). Also, emphasize on the importance of altered cerebroplacental ratio in predicting the adverse perinatal outcome in patients with abnormal cerebroplacental ratio and timely intervention in these fetus to prevent adverse perinatal outcome. Material and methods- This study, Prospective observational study, was conducted in the Department of Obstetrics & Gynecology at Tata Main Hospital, Jamshedpur, Jharkhand, periods of 1 Year and 6 Months, from January 2018 to June 2019. Patients those were attended OPD & got admitted as IPD to Tata Main Hospital at 30-36 weeks of gestation comprised the study population. Only those women who fulfilled the inclusion criteria and were willing to participate in the study voluntarily were included in the study after taking an informed consent.  Results and conclusion - In our study, 58% and 42% patients in control group were primigravida and multigravida respectively which was comparable to patients in Case group 56% and 44% respectively. Doppler flow velocity analysis can be valuable in antenatal assessment of SGA, FGR and even in AGA for prediction of late onset growth restriction and perinatal adverse outcome. By noninvasive hemodynamic monitoring of umbilical arteries (Feto-placental circulation) and middle cerebral arteries (fetal-circulation) has been a great help to improve perinatal outcome in pregnancy with comorbidities. For the prediction of adverse perinatal outcome in women with high-risk pregnancies, the best doppler index according to our study was cerebroplacental ratio (MCA/UA PI ratio). In cases with abnormal doppler, timely interventions lead to improved perinatal outcome. Hence, repeated doppler study in these pregnancies can help to reduce perinatal morbidity and mortality in high-risk cases. This study also suggested that CP ratio has the value for identifying those fetuses at risk for adverse perinatal outcome even their weights was greater than the 10th centile but are at risk for adverse outcome or late onset FGR because of an abnormal or lower CP ratio than 50th percentile value for age specific cutoff value.