Fetal biophysical profile and perinatal outcome in high risk pregnancy

ABSTRACT

This prospective study was performed to determine the impact of fetal biophysical profile [BPP] on the perinatal outcome of the high risk pregnancies. Also, the study was designed to assess the efficiency and the accuracy of BPP for predicting abnormal fetal outcome measured by low 5-minute Apgar score, fetal distress in labor, small for gestational age infants and perinatal mortality. 204 patients were included in the study. All were monitored with biophysical profile scoring [non-stress test, fetal movements, tone, breathing movements and amniotic fluid volume]. The last test within one week of delivery was used for analysis. Clinical management was dependent on the results of this monitoring. Results indicated that fetal biophysical profile was a good test in predicting normal fetal outcome [specificity was 85.89%, negative predictive value 91.78%], however, the ability of BPP in predicting abnormal outcome is still questionable [sensitivity 64.7%, positive predictive value 45.83%]. The false positive rate of the BPP in terms of diagnosis of low 5-minute Agpar score was 73.47%, for fetal distress 68.89%, for IUGR 61.33%, for perinatal mortality 87.76%. When both the NST and FM were normal the perinatal mortality was zero. It was concluded that the use of the fetal BPP monitoring improved the perinatal mortality rate. The management protocol has to be refined based on the present results. Cases with multiple risk factors must be managed cautiously when the score results are equivocal, extending the period of observation may give clear decisions in such cases. Individual risk factors need evaluation of the individual variables of the BPP