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Evaluation of normalization of cerebro-placental ratio as a potential predictor for adverse outcome in SGA fetuses

Overview of attention for article published in American Journal of Obstetrics & Gynecology, March 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • Good Attention Score compared to outputs of the same age and source (70th percentile)

Mentioned by

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27 tweeters
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2 Facebook pages

Citations

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16 Dimensions

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76 Mendeley
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Title
Evaluation of normalization of cerebro-placental ratio as a potential predictor for adverse outcome in SGA fetuses
Published in
American Journal of Obstetrics & Gynecology, March 2017
DOI 10.1016/j.ajog.2016.11.1008
Pubmed ID
Authors

Cathy Monteith, Karen Flood, Sieglinde Mullers, Julia Unterscheider, Fionnuala Breathnach, Sean Daly, Michael P. Geary, Mairead M. Kennelly, Fionnuala M. McAuliffe, Keelin O'Donoghue, Alison Hunter, John J. Morrison, Gerald Burke, Patrick Dicker, Elizabeth C. Tully, Fergal D. Malone

Abstract

Intrauterine Growth Restriction (IUGR) accounts for a significant proportion of perinatal morbidity and mortality currently encountered in obstetric practice. The primary goal of antenatal care is the early recognition of such conditions to allow treatment and optimization of both maternal and fetal outcomes. Management of pregnancies complicated by IUGR remains one of the greatest challenges in obstetrics. Frequently, however, clinical evidence of underlying uteroplacental dysfunction may only emerge at a late stage in the disease process. With advanced disease the only therapeutic intervention is delivery of the fetus and placenta. The cerebroplacental ratio (CPR) is gaining much interest as a useful tool in differentiating the "at risk" fetus in both IUGR and the appropriate for gestational age (AGA) setting. The CPR quantifies the redistribution of the cardiac output resulting in a brain sparing effect. The PORTO group, have previously demonstrated that the presence of a brain sparing effect is significantly associated with an adverse perinatal outcome in the IUGR cohort. The aim of the PORTO Study was to evaluate the optimal management of fetuses with an estimated fetal weight <10th centile. The objective of this secondary analysis was to evaluate if normalizing CPR predicts adverse perinatal outcome. 1116 consecutive singleton pregnancies with IUGR completed the study protocol over 2 years at 7 centers, undergoing serial sonographic evaluation and multivessel Doppler measurement. CPR was calculated using the pulsatility and resistance indices of the middle cerebral and umbilical artery. Abnormal CPR was defined as <1.0. Adverse perinatal outcome was defined as a composite of intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis and death. Data for CPR calculation was available in 881 cases, with a mean gestational age of 33 weeks (interquartile range, 28.7 -35.9). Of the 87 cases of abnormal serial CPR with an initial value <1.0, 52 % (n=45) of cases remained abnormal and 22% of these (n=10) had an adverse perinatal outcome. The remaining 48% (n=42) demonstrated normalizing CPR on serial sonography, and 5% of these (n=2) had an adverse perinatal outcome. Mean gestation at delivery was 33.4 weeks (n=45) in the continuing abnormal CPR group and 36.5 weeks (n=42) in the normalizing CPR group (p-value <0.001). The PORTO group has previously demonstrated that the presence of a brain-sparing effect was significantly associated with an adverse perinatal outcome in our IUGR cohort. It had been hypothesized that a normalizing CPR ratio would be a further predictor of an adverse outcome due to the loss of this compensatory mechanism. However, in this sub-analysis we did not demonstrate an additional poor prognostic effect when the CPR value returned to a value >1.0. Overall, this secondary analysis has demonstrated the importance of a serial abnormal CPR value of <1 within the <34 weeks gestation population. Contrary to our proposed hypothesis, recognition that reversion of an abnormal CPR to a normal ratio is not associated with a heightened degree of adverse perinatal outcome.

Twitter Demographics

The data shown below were collected from the profiles of 27 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 76 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 76 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 16%
Student > Master 10 13%
Student > Bachelor 9 12%
Student > Ph. D. Student 8 11%
Other 6 8%
Other 17 22%
Unknown 14 18%
Readers by discipline Count As %
Medicine and Dentistry 44 58%
Nursing and Health Professions 8 11%
Agricultural and Biological Sciences 2 3%
Psychology 1 1%
Computer Science 1 1%
Other 6 8%
Unknown 14 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 17. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 November 2018.
All research outputs
#1,541,184
of 19,682,269 outputs
Outputs from American Journal of Obstetrics & Gynecology
#1,454
of 11,354 outputs
Outputs of similar age
#34,388
of 307,067 outputs
Outputs of similar age from American Journal of Obstetrics & Gynecology
#51
of 172 outputs
Altmetric has tracked 19,682,269 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,354 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.4. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 307,067 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 172 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.