{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:27:04Z","timestamp":1792290424436,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T00:00:00Z","timestamp":1551657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","award":["(Charity No: 1037116)"],"award-info":[{"award-number":["(Charity No: 1037116)"]}],"id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the performance of screening for adverse perinatal outcome by the cerebroplacental ratio (CPR) measured within 24\u2009h prior to induction of labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of 1902 singleton pregnancies undergoing induction of labor at \u2265\u200937\u2009weeks' gestation. Doppler ultrasound was used to measure the pulsatility index (PI) in the umbilical artery (UA) and fetal middle cerebral artery (MCA) within 24\u2009h before induction of labor. The measured UA\u2010PI and MCA\u2010PI and their ratio were converted to multiples of the median after adjustment for gestational age. Univariable and multivariable logistic regression analysis was used to determine whether CPR improved the prediction of adverse perinatal outcome provided by maternal characteristics, medical history and obstetric factors. The detection rate (DR) and false\u2010positive rate (FPR) of screening by CPR were estimated for Cesarean section for presumed fetal distress and adverse neonatal outcome, which included umbilical arterial or venous cord blood pH\u2009\u2264\u20097 and\u2009\u2264\u20097.1, respectively, 5\u2010min Apgar score\u2009&lt;\u20097, admission to the neonatal intensive care unit for &gt;\u200924\u2009h or hypoxic ischemic encephalopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A combination of maternal and pregnancy characteristics, including age, weight, racial origin, previous obstetric history, pre\u2010eclampsia, gestational age at delivery and amniotic fluid volume, identified 39% of pregnancies requiring Cesarean section for fetal distress at a FPR of 10%; addition of CPR did not improve the performance of screening. In screening for adverse neonatal outcome by a combination of parity and CPR, the DR was 17% at a FPR of 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low CPR, measured within 24\u2009h prior to induction of labor, is associated with increased risk of Cesarean section for fetal distress and adverse neonatal outcome, but the performance of CPR for such surrogate measures of fetal hypoxic morbidity is poor. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20173","type":"journal-article","created":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T05:23:54Z","timestamp":1542173034000},"page":"473-480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Prediction of adverse perinatal outcome by cerebroplacental ratio in women undergoing induction of labor"],"prefix":"10.1002","volume":"53","author":[{"given":"M.","family":"Fiolna","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Kostiv","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Anthoulakis","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Institute of Medical Sciences Canterbury Christ Church University  Chatham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91333-4"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.294.6579.1051"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6655.1026"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb02573.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70283-8"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199203000-00018"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.024"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.016"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13319"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.10.013"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.10.024"},{"issue":"606","key":"e_1_2_6_13_1","first-page":"e1","article-title":"Is cerebroplacental ratio a marker of impaired fetal growth velocity and adverse pregnancy outcome?","volume":"216","author":"Khalil A","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14822"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14842"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20157"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1994.04010034.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/39.4.561"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90833-S"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14807"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.05.036"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.20173","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20173","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.20173","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20173","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T19:45:55Z","timestamp":1720554355000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.20173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,4]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1002\/uog.20173"],"URL":"https:\/\/doi.org\/10.1002\/uog.20173","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,4]]},"assertion":[{"value":"2018-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}