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Poster Session 3

(916) Middle Cerebral Artery Pulsatility Index and Cerebroplacental Ratio in Late Onset Growth Restriction and Preeclampsia

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: To determine if the presence of preeclampsia impacts the rate of abnormal middle cerebral artery (MCA) pulsatility index (PI) and cerebroplacental ratio (CPR) in pregnancies complicated by late onset fetal growth restriction (FGR).

Study Design: A retrospective cohort study was performed from 2016 to 2021 at a single academic medical center of singleton, nonanomalous pregnancies with a diagnosis of late onset FGR ( >32 weeks) who underwent weekly fetal Doppler evaluation. MCA PI and CPR were considered abnormal if they were noted to be less than the 5th percentile for gestational age. Gestational age at delivery was recorded for all patients.

Results: Five hundred forty-five pregnancies were diagnosed with late onset FGR and met inclusion criteria. Fifty-six (10%) patients were also diagnosed with preeclampsia (Table 1). When compared to pregnancies with only a diagnosis of FGR, those with both FGR and preeclampsia were more likely to have an abnormal MCA PI (31.7% vs 11.5%, p=0.001) or CPR (39.0% vs 16.0%, p< 0.001). Patients with both preeclampsia and FGR had an earlier diagnosis of abnormal CPR (34.4 vs 35.5 weeks, p=0.028) and delivered at an earlier gestational age (35.7 vs 37.6 weeks p< 0.001). Gestational age at diagnosis of abnormal MCA PI did not significantly differ between groups.

Conclusion: Pregnancies complicated by both late onset FGR and preeclampsia were more likely to have abnormal MCA PI and CPR, than pregnancies only complicated by FGR. An abnormal cerebroplacental ratio was associated with the greatest difference in findings between groups. Future work should evaluate neonatal outcomes related to these Doppler characteristics in the presence of fetal growth restriction and preeclampsia.