Sarcouncil Journal of Medicine and Surgery

Abstract: Background: Late-onset uteroplacental insufficiency poses significant risks for adverse perinatal outcomes, as background Doppler ultrasound parameters such as Umbilical Artery (UA) Pulsatility Index (PI), Middle Cerebral Artery (MCA) PI, and the Cerebroplacental Ratio (CPR) are widely used to assess fetal well-being, but their relative diagnostic accuracy remains to be fully clarified where this study aims to evaluate and compare the diagnostic performance of UA PI, MCA PI, and CPR in detecting late-onset uteroplacental insufficiency in a cohort of 100 pregnant women in addition to as a Methods refer to This prospective observational study was conducted from March 2024 to April 2025 where in this study collected One hundred pregnant women diagnosed with late-onset uteroplacental insufficiency after 32 weeks gestation underwent Doppler ultrasound assessments of UA and MCA. CPR was calculated as the ratio of UA PI to MCA PI as well as the prevalence of abnormal Doppler findings was recorded, and diagnostic parameters including sensitivity, specificity, positive and negative predictive values, and odds ratios for adverse outcomes were analyzed using SPSS so as Results were Abnormal CPR was detected in 40% of cases, higher than UA PI (25%) and MCA PI (30%). CPR demonstrated superior sensitivity (90%) and specificity (81.25%) compared to UA PI and MCA PI. The accuracy of CPR was 92%, with a strong association with adverse perinatal outcomes (odds ratio 9.1). CPR also showed higher predictive value for neonatal complications such as NICU admission and fetal distress. Finally, we concluded that CPR is a more sensitive and accurate Doppler parameter than UA PI or MCA PI alone for diagnosing late-onset uteroplacental insufficiency. Incorporating CPR into routine fetal Doppler assessment may enhance early detection and improve perinatal outcomes in affected pregnancies.