Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Universiteler Mahallesi Bilkent Cad., Cankaya, Ankara 06800, Turkey.
Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Universiteler Mahallesi Bilkent Cad., Cankaya, Ankara 06800, Turkey.
Pregnancy Hypertens. 2024 Sep;37:101148. doi: 10.1016/j.preghy.2024.101148. Epub 2024 Aug 14.
To examine the role of the cerebro-placental-uterine ratio (CPUR) in predicting composite adverse perinatal outcomes (CAPO) in patients with pregnancy-induced hypertension (PIH).
This prospective, case-control study was conducted at a tertiary hospital with 110 cases of PIH, including 70 patients with preeclampsia and 40 with gestational hypertension, and 110 healthy controls. The middle cerebral artery pulsatility index (MCA-PI), umbilical artery pulsatility index (UA-PI), and uterine artery pulsatility index (UtA-PI) were measured, and the cerebro-placental ratio (CPR=MCA-PI/UA-PI) and CPUR (CPR/UtA-PI) were calculated.
The role of CPUR in predicting CAPO in preeclampsia and gestational hypertension.
The CPR and CPUR values were lower in the PIH group compared to the control group (p < 0.001). CAPO had a negative correlation with CPR and CPUR (p < 0.001). Univariate regression analysis revealed that the likelihood of CAPO was increased four times by a low CPR value and six times by a low CPUR value. In the ROC analysis, the optimal cut-off value of CPR in predicting CAPO was 1.33 with 74 % sensitivity and 66 % specificity (area under the curve [AUC] = 0.778; p < 0.001) in PIH. For CPUR, the optimal cut-off value was 1.32, at which 82 % sensitivity and 79 % specificity in predicting CAPO (AUC=0.826; p < 0.001).
CPUR was determined to be successful with high sensitivity in predicting adverse perinatal outcomes in the presence of PIH. In addition, CPUR was more effective in predicting CAPO in patients with preeclampsia compared to gestational hypertension. CPUR can be used to predict adverse outcomes in patients with PIH.
探讨脑-胎盘-子宫比值（CPUR）在预测妊娠高血压（PIH）患者复合不良围产结局（CAPO）中的作用。
本前瞻性病例对照研究在一家三级医院进行，共纳入 110 例 PIH 患者，其中 70 例为子痫前期患者，40 例为妊娠期高血压患者，110 例为健康对照者。测量大脑中动脉搏动指数（MCA-PI）、脐动脉搏动指数（UA-PI）和子宫动脉搏动指数（UtA-PI），计算脑-胎盘比（CPR=MCA-PI/UA-PI）和 CPUR（CPR/UtA-PI）。
CPUR 在预测子痫前期和妊娠期高血压患者 CAPO 中的作用。
PIH 组的 CPR 和 CPUR 值均低于对照组（p<0.001）。CAPO 与 CPR 和 CPUR 呈负相关（p<0.001）。单因素回归分析显示，CPR 值降低会使 CAPO 的发生风险增加 4 倍，CPUR 值降低会使 CAPO 的发生风险增加 6 倍。在 ROC 分析中，CPR 预测 CAPO 的最佳截断值为 1.33，敏感性为 74%，特异性为 66%（曲线下面积[AUC]为 0.778；p<0.001）。CPUR 的最佳截断值为 1.32，预测 CAPO 的敏感性为 82%，特异性为 79%（AUC=0.826；p<0.001）。
CPUR 对预测 PIH 患者不良围产结局具有较高的敏感性。此外，CPUR 对子痫前期患者 CAPO 的预测效果优于妊娠期高血压患者。CPUR 可用于预测 PIH 患者的不良结局。
