Cerebroplacental Ratio Enhances Delivery Decisions in cases of Perceived Reduced Fetal Movement

Recent research highlights the potential of measuring the cerebroplacental ratio (CPR) during ultrasound to improve clinical decisions regarding labor in pregnancies where the mother perceives reduced fetal movement. Published online on July 10, 2025, in The Lancet Obstetrics, Gynaecology, & Women's Health, the study investigates whether this additional ultrasound parameter can better guide the timing of delivery.

In the study, researchers from the University of Groningen in the Netherlands conducted a randomized controlled trial involving women with singleton pregnancies in the cephalic position who reported decreased fetal movements near term. Participants were divided into two groups: one where CPR data was openly used to inform management decisions (revealed group), and another where standard care was provided without knowledge of CPR results (concealed group). Women with a CPR below 1.1 were recommended for expedited delivery, while those with higher ratios received expectant management.

The findings demonstrated that CPR-based management was associated with a slightly lower rate of adverse perinatal outcomes—12% compared to 15% in the usual care group—without any increase in stillbirths or neonatal deaths. Specifically, the study reported no stillbirths and only one neonatal death in each group. Additionally, the number of serious adverse events was comparable between the groups, and none were linked to the study procedures.

Lead researcher Dr. Sanne J. Gordijn explained that having access to CPR results allows clinicians to distinguish between harmless and problematic reductions in fetal movement more accurately. "When doctors know the CPR, they can tailor interventions to optimize outcomes for both mother and baby," she said. This approach underscores the importance of incorporating ultrasound assessment of fetal blood flow in obstetric management, especially when fetal wellbeing is in question.

The study provides compelling evidence that CPR measurement can serve as a valuable tool in fetal assessment, potentially reducing unnecessary early deliveries and improving perinatal health. As fetal monitoring techniques advance, integrating CPR into routine clinical practice may enhance the safety and precision of obstetric care for pregnancies complicated by perceived reduced fetal movements.

Source: MedicalXpress