Middle Cerebral Artery, Umbilical Artery Resistance Index Ratio as a predictor of Neonatal Outcome in Patients with Severe Preeclampsia

Abstract

Antenatal care is a primary defense mechanism against diagnosis of the disease and picking up of the severe cases with subsequent early management and intervention. The second line of defense mechanism which would carry the lowest maternal and fetal morbidity and mortality is the aggressive management of severe cases of high risk pregnancy. In this study which included 52 women with severe preeclampsia admitted to Ain Shams maternity university hospital our aim was to evaluate the accuracy of Middle cerebral artery/Umbilical artery resistance index ratio in predicting acidemia and low Apgar score at 1,5 minutes and birth weight in neonates of severe preeclampsia pregnant women. There was a positive significant correlation between Apgar score and (MCA/UA) RI ratio it was good predictor of neonatal birth weight and incidence of NICU admission. We found that the best cut off value of MCA/UA (RI) ratio for prediction of low Apgar score at 1&5-min, the best cutoff value for MCA/UARI ratio was 1.07 (80% sensivity,74.47% specificity), This was more predictive than either the UA-RI or the MCA-RI separately. In our study, MCA RI / UA RI ratio was found to be a good predictor of poor neonatal outcome in patients with severe preeclampsia specially in prediction of neonatal birth weight and incidence of NICU admission.