The Modified Biophysical Profile for Antepartum Fetal Wellbeing Assessment in High Risk Pregnancies

Kim, D O; Han, J Y; Kim, E S; Chae, N H; Jung, Y C; Kang, C S; Yang, J H; Kim, M Y; Ryu, H M; Han, H W

Abstract

OBJECTIVE
Our purpose was to evaluate the effectiveness of the modified biophysical profile[MBPP] for antepartum fetal wellbeing assessment in high risk pregnancies. Materials and
METHODS
From Jan.1,1996, through Dec.31,1996, 2,275 tests in 1,270 patients with singletone high risk pregnancies were performed for antepartum fetal wellbeing assessment using a MBPP consisting of nonstress test[NST] with acoustic stimulation and ultrasound evaluation of amniotic fluid index[AFI] weekly or twice a week. Nonreactive NST, significant fetal heart rate deceleration, and AFI <5 were regarded as positive results.
RESULTS
Those patients were 28.0+/-6.4 years old in mean age and the MBPPs were performed in mean 38.1+/-2.7 weeks` gestation. 1,182 patients had negative MBPPs on the last test before delivery. 88 patients had positive MBPPs such as 20 nonreactive NST[22.7%], 19 significant fetal heart rate deceleration[21.6%], 5 nonreactive NST plus oligohydramnios[5.7%], and 44 oligohydramnios alone[50.0%]. Population characteristics were not significantly different between negative and positive MBPPs. Perinatal outcome parameters included 5-minute Apgar score less than 7, thick meconium stained amniotic fluid, prematurity, cesarean section for fetal distress, small for gestational age, and perinatal death. They were significantly different between negative and positive MBPPs except perinatal death. There were two perinatal death. One perinatal death resulted from cord prolapse on the 5th day after negative MBPP of the last screen test. The false negative rate was 0.4/1000. The other occurred in positive MBPP.
CONCLUSION
The MBPP appears to be a effective primary mean of fetal surveillance in high risk pregnancies.