Amniotic-Umbilical-to-Cerebral Ratio (AUCR) as a diagnostic tool for predicting adverse perinatal outcome in pregnancies complicated by preeclampsia

PURPOSE: To compare the ability of different Doppler parameters in predicting composite adverse perinatal outcomes in women with preeclampsia. We especially aimed to analyse a possible future role of novel Doppler ratios, such as the Amniotic-Umbilical-to-Cerebral Ratio (AUCR), in a high-risk cohort, such as women suffering from preeclampsia. METHODS: A retrospective cohort study was conducted, analysing data from 151 pregnant women, consisting of 54 with preeclampsia and 97 healthy controls. Various Doppler parameters, including umbilical artery Doppler, middle cerebral artery, as well as computed ratios, such as the cerebroplacental ratio (CPR) and AUCR, were evaluated for their predictive value regarding composite adverse perinatal outcomes (CAPOs). Receiver Operating Characteristic (ROC) analyses were performed to assess the diagnostic accuracy of each parameter, and the area under the curve (AUC) was calculated. RESULTS: Our results showed that AUCR was the strongest predictor of composite adverse perinatal outcomes among women with preeclampsia. In comparison, AUCR showed low predictive accuracy in the low-risk cohort of healthy controls. The AUC ROC values for each Doppler parameter were calculated, with AUCR yielding an AUC value of 0.87, indicating good predictive performance. CONCLUSION: This study suggests that AUCR is a valuable tool for predicting composite adverse perinatal outcomes in women with preeclampsia. The findings of this investigation may lead to further studies on AUCR, but require prospective validation.