Combined bioelectric and ultrasonographic evaluation of the fetus in pregnancy induced hypertension and diabetic pregnancies

ABSTRACT

To determine the individual and combined abilities of scored non- stress test [NST] and amniotic fluid volume [AFV] assessment in predicting fetal risk in- utero, and to provide an effective screening protocol for intra-uterine fetal compromise, one hundred near term patients [50 patients with severe pregnancy - induced hypertension, and 50 gravidas with known controlled diabetes mellitus] with a singleton pregnancy, formed the subject of the study. Scored NST, and qualitative AFV assessement were weekly performed for each patient till delivery. The obstetric outcome for each pregnancy was determined [perinatal mortality, intrapartum fetal distress, 5- minutes Apgar score <7, or small for gestational age infant], and the predictive abilities of the results of the last performed tests before delivery were estimated, individually and in combination. The predictive ability of scored NST was sensitivity 75%, specificity 93.2%, PPV 60% and NPV 96.5%; the predictive ability of AFV assessment was sensitivity 58.3% specificity 92% PPV 50%, and NPV 94.2% while the predictive ability of combined NST+ AFV was sensitivity 80%, specificity 96% PPV 73%, and NPV 97%. The predictive ability of combined NST and AFV assessment was higher than that of either of the testes alone, in both studied groups. The NST was superior to AFV assessment, specially in diabetic gravidas