Cerebroplacental ratio during labour
| dc.contributor.author | Wise, Amy Juliet | |
| dc.date.accessioned | 2023-04-18T13:46:20Z | |
| dc.date.available | 2023-04-18T13:46:20Z | |
| dc.date.issued | 2022 | |
| dc.description | A dissertation submitted in fulfilment of the requirements for the degree of Master of Science in Medicine to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022 | |
| dc.description.abstract | To decrease the perinatal mortality rate in South Africa risk stratification of pregnant women needs to improve. Patients requiring referral may go undetected and deliver with the inappropriate level of care. We aimed to determine if the cerebroplacental ratio (CPR) could risk stratify women in early labour. The objectives were to describe the short-term outcomes of fetuses with a normal or abnormal CPR according to the varying definitions in the literature. Two hundred women were prospectively recruited in early labour. Ultrasound was done for biometry and multi-vessel Dopplers, the CPR was calculated. An association was looked for between an abnormal CPR and individual adverse outcomes, a composite score of adverse outcomes or the occurrence of any one adverse outcome. Our results showed that 15(7.7%) participants had a CPR<1.08, 31(16.0%) were <5th centile and 47(24.2%) <10th centile. None of the outcome variables were significantly associated with a CPR<1.08: any adverse event p=0.24, Prior score ≥3 p=0.99, Apgar<7 p=0.30, pH<7 p=0.30, admission p=0.27, fetal compromise p=0.18, resuscitation p=0.70, small for gestational age p=0.24. A CPR<5th centile had no association with a composite score of adverse outcomes (p=0.72). For a CPR cut-off <10th centile there was no association for any variable having an adverse outcome (p=0.46) or a composite score (p=0.31). After adjusting for confounders, there was no association between an abnormal CPR and an adverse outcome. There were no cases of perinatal death or neonatal encephalopathy. An abnormal CPR was not clinically useful in detecting fetuses at risk in early labour regardless of the cut off examined. It was reassuring when normal and may if combined with other parameters still prove useful for risk stratification. | |
| dc.description.librarian | NG (2023) | |
| dc.faculty | Faculty of Health Sciences | |
| dc.identifier.uri | https://hdl.handle.net/10539/35276 | |
| dc.language.iso | en | |
| dc.school | School of Clinical Medicine | |
| dc.title | Cerebroplacental ratio during labour | |
| dc.type | Dissertation |
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