An Observational Study to Assess the Role of Modified Biophysical Profile and Doppler Ultrasound in Determining the Fetal Well-being in Low-risk Term Pregnancy

Abstract

Aims and objectives:To determine the tests of antepartum fetal surveillance such as Doppler ultrasound, modified biophysical profile (MBP) alone, and in combination for assessing adverse neonatal outcome in term low-risk pregnancy. Materials and methods: Prospective observational study was done in a rural tertiary care center for 1 year duration. A total of 169 term lowrisk pregnant women were included in the study and fetal surveillance tests such as MBP and Doppler ultrasound were done. The sensitivity of MBP and Doppler analysis in predicting the neonatal outcome using parameters such as birth asphyxia, meconium-stained amniotic fluid (MSAF), neonatal intensive care unit (NICU) admission, and Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score were assessed. Results: Among 169 pregnant women, MBP was normal in 66% and abnormal in 34% cases. 150 (89%) showed normal Doppler indices and 19 (11%) were found abnormal. Those with normal MBP and with normal Doppler were found to have better neonatal outcome and this was statistically meaningful (p <0.00). Doppler sensitivity was 37.5% and MBP was 62.5%. The results of combination of MBP and Doppler showed higher sensitivity of 73.5%. Conclusion: Modified biophysical profile was found to be a more significant than Doppler analysis in determining fetal well-being and in presage of fetal distress. Together MBP and Doppler analysis has yielded a higher sensitivity to detect adverse neonatal outcome. Clinical significance: Even if Doppler ultrasound is unavailable for surveillance, MBP alone can be the best modality to determine reassuring status in low-risk pregnancy.