Title: Predictive value of Biophysical Profile score in Intrauterine Growth Restricted Fetuses
Authors: Dr Sushma Makhaik, Dr Neeti Aggarwal, Dr Sanjiv Sharma, Dr Anupm Jhobta, Dr Ashwani Tomar, Dr Sumala Kapila
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.104
Abstract
Introduction: High risk of perinatal mortality is seen in IUGR fetuses. The Biophysical Profile Score can predict the perinatal outcome and hence timely intervention can improve the fetal outcome.
Objective: To predict perinatal outcome by Biophysical Profile Score (BPS) in Intrauterine Growth Restricted Fetuses.
Material and Methods: Our study included 25 IUGR fetuses at 28-40 weeks of gestation without any congenital anomaly. Five variables i.e NST, FBM, FM, FT and AFV were recorded to calculate BPS. Adverse perinatal outcome was assessed as still birth and neonatal death due to fetal hypoxia, APGAR score of less than 7 at 5 minutes, LSCS for fetal asphyxia and admission into ICU.
Observations: Negative predictive value of normal BPS for LSCS, low APGAR score, ICU admission and perinatal mortality was 52.9%, 83.2%, 70% and 100% respectively. Positive predictive value of abnormal BPS was 75% for LSCS, 62.5% for low APGAR score/ICU admission and 37.5% for perinatal mortality.
Conclusion: Low BPS has high predictive valve for adverse perinatal outcome. NST and FM had better predictive value for fetal hypoxia.
Keywords/Abbreviations: IUGR - Intrauterine Growth Restriction, NST -Non Stress Test, FBM - Fetal Breathing Movements, FM - Fetal Movements, FT- Fetal Tone, AFV - Amniotic Fluid Volume, BPS - Biophysical Profile Score, LSCS - Lower Segment Cesarian Section, ICU - Intensive Care Unit, NVD – Normal Vaginal Delivery.
References
- Evertson LR, Gauthier RJ, Schifrin BS, Paul RH. Antepartum fetal heart rate testing.1. Evolution of the non-stress test. Am J ObstetGynecol 1979;133:29-33.
- Manning FA, Platt LD, Sipos L. Antepartum fetal evaluation: Development of a fetal biophysical profile score. Am J ObstetGynecol 1980;136:787-95.
- Ianniruberto A, Tejani E. Ultrasonographic study of fetal movements. Semin Perinatol1981;5:175-81.
- Vintzileos AM,Campbell WA, Nochimson DJ, Weinbaum PJ. The use and misuse of fetal biophysical profile. Am J ObstetGynecol1987;156:527-33.
- Manning FA, Morrison I, Lange IR, Harman CR, Chamberlain PF. Fetal assessment based on fetal biophysical profile scoring: Experience in 12,620 referred high risk pregnancies.1 Perinatal mortality by frequency and etiology. Am J ObstetGynecol1985;151:343-50.
- Manning FA, Morrison I, Harman CR, Lange IR, Menticoglou S. Fetal assessment based on fetal biophysical profile scoring: Experience in 19,221 referred high risk pregnancies. 11. An analysis of false negative fetal deaths. Am J ObstetGynecol1987;157:880-84.
- Platt LD, Eglinton GS, Sipos L, Broussard PM, Paul RH. Further experience with the fetal biophysical profile. Obstet Gynecol 1983;61:480-85.
- Johnson JM, Harman CR, Lange IR, Manning FA. Biophysical Profile Scoring in the management of the post term pregnancy: A analysis of 307 patients. Am J ObstetGynecol1986;154:269-73
- Baskett TF, Gray JH, Prewett SJ, Young LM, Allen AC. Antepartum fetal assessment using a fetal biophysical profile score. Am J Obstet Gynecol 1984;148:630-33.
- Mills MS, James DK, Slade S. Two-tier approach to biophysical assessment of the fetus. Am J ObstetGynecol1990;163:12-17.
- Manning FA, Morrison I, Harman CR, Menticoglou SM. The abnormal fetal biophysical profile score: V. Predictive accuracy according to score composition. Am J ObstetGynecol1990;162:918-27.
- Vintzileos AM, Gaffney SE, Salinger LM, Kontopoulos VG, Campbell WA, Nochimson DJ. The relationships among the fetal biophysical profile, umbilical cord pH, and Apgar scores. Am J ObstetGynecol1987;157:627-31.
- Vintzileos AM, Fleming AD, Scorza WE, Wolf EJ, Balducci J, Campbell WA, Rodis JF. Relationship between fetal biophysical activities and umbilical cordblood gas values. Am J ObstetGynecol1991;165:707-13.
- Nijhuis IJM, Hof JT, Mulder EJH, Nijhuis JG, Narayan H, Taylor DJ, Visser GHA. Fetal heart rate in relation to its variation in normal and growth retarded fetuses. Er J ObstetGynecol& Reproductive Biology 2000;89:27-33.
- Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid. 1. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. AmJ Obstet Gynecol 1984;150: 245-49.
- Bastide A, Manning F, Harman C, Lange I, Morrison I. Ultrasound evaluation of amniotic fluid: outcome of pregnancies with severe oligohydramnios. Am J Obstet Gynecol 1986;154:895-900.