Fetal Biophysical Profile Monitoring and Perinataloutcome

Abstract

A prospective study of 109 high risk pregnancies on whom 279 fetal biophysical profile (FBP) examinations were performed showed positive and negative predictive values of 100% and 71.4%, respectively in the last FBP examination prior to delivery. The study confirmed other reports in the literature of a high correlation between normal examination and satisfactory perinatal outcome. The absence of perinatal mortality within one week of a normal FBP examination, which was also in agreement with other reported studies, reaffirms the reassuring nature of a normal examination. The high positive predictive value in our study may be due to several factors, including the use of a protocol which ensured standardization of the patient's condition prior to examination as well as repeat evaluations after non-reassuring tests. FBP evaluation is considered a simple, reliable and useful examination for the management of high risk pregnancies. Its main value would appear to be a reduction in the number of high risk pregnancy patients who would otherwise have been admitted on the basis of the clinical findings. D Makanjuola, EO Akande, T Malabarey, AA Al-Meshari, Fetal Biophysical Profile Monitoring and Perinataloutcome. 1992; 12(3): 241-246 Fetal asphyxia causes approximately half of stillbirth [1][2][3][4] and often manifest with intrauterine growth retardation. It also contributes significantly to perinatal mortality and morbidity. Therefore, the recognition and monitoring of the fetus at risk cannot be over emphasized.With the advent of static and realtime ultrasonography the evaluation of the fetus progressed from the mere acquisition of the fetal age to detection of fetal anomalies and subsequently to a direct physical examination of the fetus-fetal biophysical profile (FBP). Several authors [3][4][5][6][7] have shown the superiority of fetal biophysical profile (FBP) consisting basically of fetal heart rate reactivity (FR), fetal breathing movements (FBM), fetal movement (FM), fetal tone (FT), and qualitative amniotic fluid volume (AFV) as compared with any other single test in monitoring the fetus at risk. A score criteria whereby eight or more was considered normal while seven or less suggested a fetus at risk was used [3][4][5][6][7]. However, Vintzileos et al [8] expressed the use and misuse of the fetal biophysical profile and emphasized the value of the score components in order to reduce false positive and false negative rates. Manning et al [9] in a recent communication also demonstrated the inequality of the various score components and showed that predictive accuracy is related to score composition.We wish to report our experience on a prospective study on 109 consecutive high risk pregnancies in which the results of the FBP are compared with the perinatal outcome as judged by the presence or absence of fetal distress in labor, neonatal one minute Apgar score and perinatal mortality. We do not have any report of such work done in this environment as of now.