Department of Obstetrics & Gynecology, University of Ghana Medical School, Accra, Ghana.
Department of Obstetrics & Gynecology, Korle-Bu Teaching Hospital, Accra, Ghana.
Int J Gynaecol Obstet. 2020 Aug;150(2):248-253. doi: 10.1002/ijgo.13196. Epub 2020 Jun 15.
To assess the role of the cerebro-placental ratio (CPR) in predicting adverse fetal outcomes among women with sickle cell disease (SCD).
A prospective cohort study at Korle-Bu Teaching Hospital, Accra, Ghana, between January and June 2016. Pregnant women with SCD at 34 gestational weeks or more underwent weekly fetal umbilical and middle cerebral artery Doppler assessment until delivery. Participants were categorized into two study arms based on CPR (<1.1 or ≥1.1). The primary outcome, a composite of adverse perinatal outcomes including intrauterine growth restriction, stillbirth, low birthweight, and neonatal intensive care unit admission, was compared between groups.
Overall, 48 pregnant women with SCD were enrolled, and 5 had a fetus with CPR less than 1.1. Low CPR (<1.1) had a sensitivity and specificity of 29.4% and 100%, respectively, for predicting composite adverse perinatal outcomes. Sensitivity and specificity were, respectively, 100% and 93.5% for predicting stillbirth, and 40.2% and 97.4% for predicting low birthweight. Perinatal outcomes did not differ between the two major sickle cell genotypes (hemoglobin SS and hemoglobin SC).
Among women with SCD, CPR less than 1.1 was associated with adverse perinatal outcomes, particularly low birthweight and stillbirth.
评估脑胎盘比值（CPR）在预测镰状细胞病（SCD）女性不良胎儿结局中的作用。
这是 2016 年 1 月至 6 月在加纳科勒布教学医院进行的一项前瞻性队列研究。34 孕周或以上的 SCD 孕妇每周进行胎儿脐动脉和大脑中动脉多普勒评估，直至分娩。根据 CPR（<1.1 或≥1.1）将参与者分为两组研究组。主要结局为包括宫内生长受限、死胎、低出生体重和新生儿重症监护病房入院在内的不良围产结局的复合指标，比较两组间的差异。
共有 48 名 SCD 孕妇入组，其中 5 名胎儿的 CPR<1.1。低 CPR（<1.1）预测复合不良围产结局的敏感性和特异性分别为 29.4%和 100%。预测死胎的敏感性和特异性分别为 100%和 93.5%，预测低出生体重的敏感性和特异性分别为 40.2%和 97.4%。两种主要镰状细胞基因型（血红蛋白 SS 和血红蛋白 SC）之间的围产结局无差异。
在 SCD 女性中，CPR<1.1 与不良围产结局相关，尤其是低出生体重和死胎。
