Objective: 1) To determine the prevalence of abnormal cerebro-placental Doppler indices ratio [CPR] in hypertensive disorders of pregnancy. 2) To analyze the association between abnormal CPR and perinatal outcomes.

Materials and Methods: A cross sectional study was conducted between July 2016 and July 2017 at Bhumibol Adulyadej Hospital. One hundred forty-eight singleton pregnancies with hypertensive disorders during 28 to 40 weeks of gestation were enrolled. Doppler ultrasound analysis of the fetal umbilical and middle cerebral arteries were performed, and the CPR was calculated and interpreted. Patients were followed up until delivery and perinatal outcomes were analyzed.

Results: The present study showed abnormal CPR in 35.62% (52) of the population (148). Pregnancies with abnormal CPR had a significantly increased risk of small for gestational age [SGA] (odds ratio [OR] 3.15; 95% confidence interval [CI] 1.24 to 7.98; p = 0.013), and neonatal intensive care unit [NICU] admission (OR 2.19; 95% CI 1.07 to 4.47; p = 0.030). There was no significant difference in preterm delivery, non-reassuring fetal heart rate pattern, low Apgar score, hypoglycemia, hypothermia, and hyperbilirubinemia.

Conclusion: The prevalence of abnormal CPR in hypertensive disorders of pregnancy was 35.62%. Compared to pregnancies with normal CPR, pregnancies with abnormal CPR were significantly associated with SGA and NICU admission. CPR parameters should be interpreted with caution for assessing the fetal status and prediction of pregnancy outcomes in hypertensive disorders of pregnancy.

Keywords: CPR, Perinatal outcomes, Hypertensive disorders of pregnancy