- What does the cerebroplacental ratio (CPR) measure in gestational ultrasound?
- A) Blood flow between the brain and the heart
- B) Ratio of blood flow between the fetal middle cerebral artery and the umbilical artery
- C) Blood flow from the placenta to the fetus
- D) Blood flow between the fetal lungs and liver
- What is the primary clinical significance of an abnormal CPR in pregnancy?
- A) Fetal gender determination
- B) Indication of fetal anemia
- C) Predictor of adverse perinatal outcomes
- D) Estimation of fetal weight
- Which arteries are assessed to calculate the cerebroplacental ratio (CPR)?
- A) Umbilical artery and uterine artery
- B) Middle cerebral artery and femoral artery
- C) Middle cerebral artery and umbilical artery
- D) Umbilical artery and renal artery
- A decreased CPR is most commonly associated with which condition?
- A) Fetal macrosomia
- B) Fetal growth restriction (FGR)
- C) Polyhydramnios
- D) Fetal cardiac anomalies
- How is CPR calculated?
- A) CPR = Middle Cerebral Artery Pulsatility Index / Umbilical Artery Pulsatility Index
- B) CPR = Umbilical Artery Pulsatility Index / Middle Cerebral Artery Pulsatility Index
- C) CPR = Middle Cerebral Artery Diameter / Umbilical Artery Diameter
- D) CPR = Umbilical Artery Diameter / Middle Cerebral Artery Diameter
- What is considered a normal CPR value at term?
- A) Greater than 1.0
- B) Less than 1.0
- C) Exactly 1.0
- D) Greater than 2.0
- A CPR less than the 5th percentile is indicative of:
- A) Fetal overgrowth
- B) Adequate fetal oxygenation
- C) Increased risk of intrapartum fetal distress
- D) Decreased risk of neonatal intensive care admission
- In which trimester is CPR most commonly assessed?
- A) First trimester
- B) Second trimester
- C) Third trimester
- D) Immediately after birth
- What is the Doppler finding in the middle cerebral artery in cases of brain-sparing effect due to fetal hypoxia?
- A) Increased pulsatility index
- B) Decreased pulsatility index
- C) Normal pulsatility index
- D) Absent end-diastolic flow
- Which condition is NOT typically associated with an abnormal CPR?
- A) Preeclampsia
- B) Fetal growth restriction
- C) Gestational diabetes with normal fetal growth
- D) Maternal anemia
- A low CPR in late pregnancy may suggest a need for:
- A) Immediate cesarean section
- B) Closer fetal surveillance and possible early delivery
- C) Increased maternal fluid intake
- D) Postponing delivery until full term
- Which ultrasound modality is primarily used to assess the CPR?
- A) B-mode ultrasound
- B) Doppler ultrasound
- C) 3D ultrasound
- D) M-mode ultrasound
- In a fetus with growth restriction, an abnormal CPR suggests:
- A) Normal placental function
- B) Decreased placental resistance
- C) Increased risk of perinatal morbidity and mortality
- D) Increased placental blood flow
- An elevated CPR in early gestation is most likely to be:
- A) Normal
- B) Pathological
- C) Indicative of fetal compromise
- D) Indicative of maternal hypertension
- The cerebroplacental ratio can help distinguish between:
- A) Symmetrical and asymmetrical fetal growth restriction
- B) Congenital infections
- C) Chromosomal abnormalities
- D) Types of maternal anemia
- What is the clinical significance of an increased umbilical artery pulsatility index (UA-PI) in conjunction with a decreased CPR?
- A) Normal fetal well-being
- B) Impaired placental function and fetal hypoxia
- C) Maternal hypertension
- D) Increased risk of gestational diabetes
- In fetal surveillance, a persistently low CPR may prompt:
- A) No change in management
- B) Consideration of preterm delivery
- C) Reduction in maternal activity
- D) Increase in caloric intake for the mother
- Which fetal outcome is NOT commonly associated with an abnormal CPR?
- A) Preterm birth
- B) Low Apgar scores
- C) Normal birth weight
- D) Stillbirth
- In the presence of normal fetal growth, a low CPR may indicate:
- A) Fetal anemia
- B) Impending fetal asphyxia
- C) Normal fetal well-being
- D) Maternal malnutrition
- Which of the following does NOT directly affect the CPR?
- A) Maternal blood pressure
- B) Placental resistance
- C) Fetal brain oxygenation
- D) Amniotic fluid volume
- What is the significance of finding an abnormal CPR in a patient with preeclampsia?
- A) It indicates normal placental function
- B) It suggests a high risk of fetal compromise
- C) It is of no clinical significance
- D) It indicates maternal heart disease
- Which intervention may be considered in a fetus with a persistently low CPR and signs of compromise?
- A) Prolongation of pregnancy
- B) Early delivery
- C) Increased maternal rest
- D) Increased maternal fluid intake
- What does a high middle cerebral artery pulsatility index (MCA-PI) indicate in the context of CPR?
- A) Normal fetal condition
- B) Brain-sparing effect
- C) Reduced cerebral blood flow
- D) Increased risk of fetal infection
- When assessing CPR, a finding of reversed end-diastolic flow in the umbilical artery suggests:
- A) Normal fetal circulation
- B) Severe placental insufficiency
- C) Mild placental insufficiency
- D) Increased placental blood flow
- A fetus with a low CPR is monitored with Doppler studies. Which additional test might be used to assess fetal well-being?
- A) Non-stress test (NST)
- B) Maternal blood pressure
- C) Biophysical profile (BPP)
- D) Fetal fibronectin test
- In a high-risk pregnancy, how often might CPR be assessed?
- A) Once in each trimester
- B) Weekly or bi-weekly
- C) Only at term
- D) Only if fetal growth is abnormal
- What physiological adaptation is indicated by a low CPR in a fetus?
- A) Increased cerebral blood flow due to hypoxia
- B) Decreased cerebral blood flow
- C) Increased placental blood flow
- D) Normal adaptation to intrauterine environment
- A decreased CPR in the third trimester is a predictor of:
- A) Fetal macrosomia
- B) Intrauterine growth restriction (IUGR)
- C) Normal term delivery
- D) Fetal polycythemia
- Which of the following best describes the relationship between CPR and fetal hypoxia?
- A) Direct correlation
- B) Inverse correlation
- C) No correlation
- D) Random correlation
- A low cerebroplacental ratio (CPR) can indicate which of the following conditions?
- A) Fetal macrosomia
- B) Fetal anemia
- C) Fetal hypoxia
- D) Fetal renal agenesis