Association Between Cerebroplacental Uterine Ratio With Fetal Gender In Normal And Intrauterine Growth Restricted Pregnancies

Abstract

Background: Antenatal ultrasound plays a vital role in monitoring fetal and maternal wellbeing during pregnancy. Doppler ultrasound is widely used for assessing fetoplacental circulation, and cerebroplacental uterine ratio (CPUR) is considered an important marker for detecting uteroplacental insufficiency, fetal growth restriction (FGR), and adverse perinatal outcomes. The relationship between CPUR and fetal gender remains insufficiently explored, particularly in South Asian populations.

Methodology: This prospective case-control study was conducted on 144 pregnant women attending Shervon London Healthcare, Model Town Lahore. Participants were aged 18–40 years with gestational age between 15–40 weeks. Doppler ultrasound was performed to measure pulsatility indices of the middle cerebral artery (MCA), uterine artery (UTA), and umbilical artery (UMB A), and CPUR was calculated. Fetal gender was determined using ultrasonographic assessment. Data were analyzed using SPSS version 25.

Results: A total of 144 fetuses were included in this study, with 76 (52.8%) males and 68 (47.2%) females. The average maternal age was 28.38 ± 4.33 years. Fetal measurements showed mean values of 69.42 mm for biparietal diameter (BPD), 260.17 mm for head circumference (HC), 236.13 mm for abdominal circumference (AC), and 50.09 mm for femur length (FL), with an average estimated fetal weight of 1406.40 grams. Doppler findings showed mean values of 1.05 for umbilical artery pulsatility index (UA PI), 0.65 for resistance index (RI), 3.16 for S/D ratio, and 1.98 for middle cerebral artery pulsatility index (MCA PI). Most placentas were located in the fundoposterior region (50.6%), and Grade 2 placenta was the most common (51.4%). The majority of fetuses had normal CPUR and CPR values. Only 12 fetuses had abnormal CPUR, including 5 females and 7 males, while abnormal CPR was found in only 2 male fetuses. Statistical analysis showed no significant relationship between fetal gender and CPUR (p = 0.68) or CPR (p > 0.05). This means that fetal gender does not affect CPUR or CPR values.

Conclusion: CPUR is a useful Doppler metric for fetoplacental and uteroplacental assessment, but fetal gender showed no significant association with CPUR or CPR in normal or IUGR pregnancies. Most fetuses had normal values, and abnormal findings were similarly rare in both genders. Thus, gender does not affect these indices, which remain reliable markers of fetal well-being without need for gender-specific interpretation.