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Fetal Biophysical Profile Scoring
H.R. HaghighatKhah,M. Sanei Taheri
Iranian Journal of Radiology , 2009,
Abstract: "nFetal biophysical profile scoring is a sonographic-based method of fetal assessment first described by Manning and Platt in 1980. "nThe biophysical profile score was developed as a method to integrate real-time observations of the fetus and his/her intrauterine environment in order to more comprehensively assess the fetal condition. These findings must be evaluated in the context of maternal/fetal history (i.e., chronic hypertension, post-dates, intrauterine growth restriction, etc), fetal structural integrity (presence or absence of congenital anomalies), and the functionality of fetal support structures (placental and umbilical cord). For example, acute asphyxia due to placental abruption may result in an absence of the acute variables of the biophysical profile score (fetal breathing movements, fetal movement, fetal tone, and fetal heart rate reactivity) with a normal amniotic fluid volume. With post maturity the asphyxial event may be intermittent and chronic resulting in a decrease in amniotic fluid volume, but with the acute variables remaining normal. "nWhile the 5 components of the biophysical profile score have remained unchanged since 1980 (Manning, 1980), the definitions of a normal and abnormal parameter have evolved with increasing experience. "nIn 1984 the definition of oligohydramnios was increased from < 1cm pocket of fluid to < 2.0 x 1.0 cm pocket. Oligohydramnios is now defined as a pocket of amniotic fluid < 2.0 x 2.0 cm (Manning, 1995a) "nIf the four ultrasound variables are normal, the accuracy of the biophysical profile score was not found to be significantly improved by adding the non-stress test. As a result, in 1987 the profile score was modified to incorporate the non-stress test only when one of the ultrasound variables was abnormal (Manning 1987). Table 1 outlines the current definitions for quantifying a variable as present or absent. "nEach of the 5 components of the biophysical profile score does not have equal significance. Fetal breathing movements, amniotic fluid volume, and the non-stress test are the most powerful variables. For example, when the biophysical profile score is 2, the perinatal mortality varies between 428/1000 with only fetal movement present to 66/1000 if the non-stress test is reactive and all of the ultrasound parameters are absent (Manning 1990b). Some authors have, therefore, proposed utilization of a modified biophysical profile that incorporates only the non-stress test and amniotic fluid volume (Miller 1996). Although the positive predictive value of these 2 tests is equivalent to a biophysic
Comparison of the Revised Biophysical Profile Test with Complete Biophysical Profile Test in Pregnancy
Fatemeh Lolaha,Ahmad Javadi,Azadeh Basharkhah,Omid Mashrabi,Sina Zarrintan,Farnaz Sepasi
Research Journal of Biological Sciences , 2012,
Abstract: One of the best tests for assessment of fetus is biophysical profile test and performance of this has significant effects in fetus health and outcome of pregnancy. The aim of this study, is comparison of modified biophysical profile test with complete biophysical profile test. A cross-sectional and prospective analytical study that performed in Kosar hospital of Qazvin at 2004S, 600 high risk pregnant women of 15-45 years of ages that gestational age was >32 weeks were chosen for any patient both of test were performed and then sensitivity, specificity, positive and negative predictive value were compared together and then analyzed with statistics. Sensitivity in complete biophysical profile was 98.5% and in modified biophysical profile was 98.4%. Specificity in complete biophysical profile was 82.6% and in modified biophysical profile was 81.2%. Positive predictive value in complete biophysical profile was 99.7% and in modified biophysical profile was 99.7%. Modified biophysical profile test can be replaced for assessment of fetus health and outcome of pregnancy.
A. Jamal,V. Marsoosi,L. Eslamian K. Noori
Acta Medica Iranica , 2007,
Abstract: "nThe original biophysical profile is time consuming and costly. This study was performed to compare diagnostic value of the original fetal biophysical profile to the modified biophysical profile. Patients were selected from high risk pregnancies referred for fetal assessment and were randomly assigned to two groups. The measures of outcomes were perinatal mortality, Cesarean section for abnormal test, meconium-stained amniotic fluid and 5-minute Apgar score < 7. Diagnostic values of tests were assessed in terms of the incidence of abnormal outcome. In addition comparisons between the positive and negative predictive values of each of these tests as well as the sensitivity and specificity of the tests were reviewed. A total of 200 patients were entered into the study; 104 pregnancies were managed by the original biophysical profile and 96 pregnancies by the modified biophysical profile. There were 30 abnormal (31.3%) in modified biophysical profile and 24 (23.1%) abnormal tests in original one. There was significant difference in the incidence of meconium passage between two groups. Cesarean section for abnormal tests was 27 of 30 abnormal test (90%) in modified and 22 of 24 (91.6%) in original profile that was similar in both groups. There was not significant difference in Apgar score < 7 between two groups. We did not find significant difference with comparison of the sensitivity, specificity and negative predictive value of two tests for all measures of outcome except the positive predictive value of meconium passage. Original biophysical profile is more costly and time consuming than modified one.
M. Pourissa,S. Refahi,M. Javid Majd A. Mardi
Acta Medica Iranica , 2008,
Abstract: Biophysical profile (BPP) test is the most commonly used antenatal test of fetal well-being. Purpose of this study is determining the influence of acoustic stimulation (AS) on BPP testing time. About 55 pregnant women at 35 to 42 weeks who referred to department of Obstetric & Gynecology at university of medical sciences, Tabriz, Iran, were selected randomly. We used abdominal ultrasound guidance to place buzzer like device with power of 110 dB at the skin surface of the maternal abdomen, close to the fetal head. BPP test performed and BPP mean testing time calculated before and after AS. Data compared and analyzed by paired t-test. The results showed that fetal AS reduces the overall mean testing time from 24 minutes to 5 minutes. This clinical application can be helpful in busy clinics when rapid assessment of fetal health is required.
M Z Pezeshki,M H Daghighi,M Pourisa,S H Shahin
Acta Medica Iranica , 2008,
Abstract: "nMother's mental health status during pregnancy has important effects on fetal growth and development. However, there are few studies concerning association of maternal depression and biophysical profile (BPP) of the fetus. We performed this research to know if maternal depression has any association with fetal BPP score. For measuring depression, Farsi version of Patient Health Questionnaire-9 (PHQ-9) was completed. A total of 100 pregnant women in their third trimester (>24 weeks) who had not hyperthyroidism, hypothyroidism, eclampsia and preeclampsia, fever, infection, diabetes or a fetus with intrauterine growth retardation (IUGR) and were not using any medication entered the study. Spearman correlation coefficient between the score of PHQ-9 questionnaire and BPP score was -0.08 (P = 0.43). Based on Kruskal Wallis test, there was no difference in BPP score of depressed and nondepressed women (P = 0.65). We found no relationship between maternal depression and BPP score in third trimester of pregnancy. Further studies for elucidating neuro-hormonal mechanisms related to the result of our study are suggested
The relationship between fetal biophysical profile and cord blood PH
Valadan M,Moridi M,Davari Tanha F,Rahimi Sher Baf F
Tehran University Medical Journal , 2009,
Abstract: "nBackground: The Biophysical Profile (BPP) is a noninvasive test that predicts the presence or absence of fetal asphyxia and, ultimately, the risk of fetal death in the antenatal period. Intervention on the basis of an abnormal biophysical profile result has been reported to yield a significant reduction in prenatal mortality, and an association exists between biophysical profile scoring and a decreased cerebral palsy rate in a given population. The BPP evaluates five characteristics: fetal movement, tone, breathing, heart reactivity, and amniotic fluid (AF) volume estimation. The purpose of study was to determine whether there are different degree of acidosis at which the biophysical activity (acute marker) are affected. "nMethods: In a prospective study of 140 patients undergoing cesarean section before onset of labor, the fetal biophysical profile was performed 24h before the time of cesarean and was matched with cord arterial PH that was obtained from a cord segment (10-20cm) that was double clamped after delivery of newborn. (using cord arterial PH less than 7.20 for the diagnosis of acidosis). "nResults: The fetal biophysical profile was found to have a significant relationship with umbilical blood PH. The sensitivity, specificity, positive predictive value, negative predictive value of fetal biophysical profile score were: 88.9%, 88.6%, 50%, 98.1%. "nConclusion: The first manifestations of fetal acidosis are nonreactive nonstress testing and fetal breathing loss; in advanced acidemia fetal movements and fetal tone are compromised. A protocol of antepartum fetal evaluation is suggested based upon the individual biophysical components rather than the score alone.
The Professional Medical Journal , 2010,
Abstract: To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcomeby early detection of fetal hypoxia. Design: Co relational study: Place and Duration of Study: The study was carried out for a period of one yearfrom Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. Patients and Methods: All patientswith history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected andtheir BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored duringlabor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes andthose having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score.Results: During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73had aBPP score of 9-10/10, 21 patients had a score of 7-8/10 and 6 patients had 4-6/10.In 2 patients with 4/10score emergency caesarean section ledto the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7-8/10.Only 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. Conclusion: The fetal BPP appears to be an effectivetechnique for assessment of fetal condition.
Experiencia con el perfil biofísico fetal en nuestro medio Experience with the fetal biophysical profile in our environment  [cached]
Luis Raúl Martínez González,Wilfredo Torres García,Caridad Pérez Martínez
Revista Cubana de Obstetricia y Ginecolog?-a , 1997,
Abstract: Se realizó un estudio del bienestar fetal a un grupo de 213 embarazadas con riesgo en nuestro Hospital Docente Ginecoobstétrico "Justo Legón Padilla" durante los meses de octubre de 1993 a mayo de 1994, mediante el perfil biofísico fetal, según los criterios de cuantificación de las variables propuestas por Manning. Se encontró el 90,60 % de perfiles biofísicos normales, el 2,30 % fueron anormales y un 6,60 % sospechosos. Se comprobó que cuando el perfil biofísico resulta anormal aumentan significativamente el número de cesáreas por sufrimiento fetal agudo, el apgar bajo a los 5 minutos de vida así como la cantidad de líquidos amnióticos meconiales. Se demostró que el parámetro biofísico movimientos fetales corporales fue el de mayor valor predictivo (80). Se determinó, con la evaluación del perfil biofísico, su alta sensibilidad (88), especificidad (94) y elevado poder discriminante con un Wilk's lambda de 0,2836. Se trata de un método prometedor para detectar riesgos del producto, aún teniendo como parámetros solamente los movimientos corporales, el tono y el líquido amniótico. A fetal welfare study was conducted among 213 pregnant women at risk in the "Justo Legón Padilla" Gynecoobstetric Teaching Hospital from October, 1993, to May, 1994. It was used the fetal biophysical profile according to the quantification criteria of the variables proposed by Manning. 90.60 % of the biophysical profile were normal, 2.30 % abnormal, and 6.60 % suspicious. It was demonstrated that when the biophysical profile is abnormal there is a significant increase of cesarotomies due to acute fetal suffering,of the low Apgar the 5th minute of life, as well as of the amount of meconium amniotic fluids. It was proved that the corporal fetal movements was the biophysical parameter of highest predictive value (80). Through the evaluation of the biophysical profile it was determined its high sensitivity, (88) specificity (94) and elevated discriminating power with a Wilks Lambds of 0.2836. The corporal movements, the tone, and the amniotic fluid are the only parameters considered in this method.
The Professional Medical Journal , 2006,
Abstract: A pregnancy is defined as high risk when there is a likelihood of anadverse outcome to the woman and or her baby that is greater than the incidence of that outcome in the generalpregnant population. Objectives: To determine the efficacy and predictive value of biophysical profile in detectingperinatal outcome. Design: Observational study. Setting: Obstetrics and Gynaecology department, PNS SHIFA KarachiPeriod: From February 2003 to October 2003. Patients and Methods: The study was carried on 100 randomlyselected high risk pregnant patients who reported to gynae OPD or were referred from different armed forces hospitalsfrom all over sindh . Manning’s biophysical profile excluding nonstress test and including only ultrasound basedparameters were employed for fetal screening ( BPS 8/8). These parameters include four variables i.e fetal breathingmovement, fetal tone, fetal movements, and amniotic fluid volume. Nonstress test and Doppler studies were used asbackup tests where biophysical profile was abnormal. All cases selected were admitted in the hospital and each hadan admission biophysical profile followed by subsequent monitoring. Parameters for abnormal perinatal outcome includefetal distress in labour, five minute apgar score less than 7/10, admission of newborn to intensive care unit and stillbirthor neonatal death. The result of last biophysical profile is compared with perinatal outcome. For statistical analysis thepredictive value, specificity and sensitivity are used to determine the ability of biophysical profile to predict an abnormalperinatal outcome. Results: Out of 100 cases 92 had a normal biophysical profile in the last scan of 8/8. 90 cases hada normal perinatal outcome with A/S > 7/10. In two cases A/S at 1 and 5 minute is < 7/10 with one baby shifted tonursery for delayed cry. 08 cases had an abnormal biophysical profile with scores of 4/8 and 2/8. There was one falsepositive who showed abnormal biophysical profile but baby was born with an A/S of 8/10 at 05 minutes. There was noneonatal death in this study group. The sensitivity of biophysical profile was 77.7%, specificity 98.90%. predictive valuefor a positive test was 87.5%, predictive value for a negative test was 97.8%. Conclusion: Biophysical profile is highlyaccurate and reliable test of diagnosing fetal status.
Correlation Between Biophysical Profile and Middle Cerebral/Umbilical Artery Resistance Index Ratio in the Assessment of Prenatal Outcome in High Risk Pregnancies
Nazanin Eshraghi,Mohammad kazem Tarzamni,Isa Adibfar
Iranian Journal of Radiology , 2009,
Abstract: Introduction: Antenatal fetal surveillance tests have led to a significant decrease in perinatal mortality and morbidity rates, especially in high risk pregnancies (e.g placenta previa, intrauterine growth retardation). But there is no concurrence on the best and accurate modality yet. The aim of this study is to evaluate the accuracy of antenatal assessment with biophysical profile and Doppler sonography (cerebral and umbilical artery) regarding fetal acidosis and asphyxia. "nMaterials and Methods: This is a cross-sectional study on fetuses of seventy women with a 28-42 week singleton pregnancy who had hypertension (pre eclampsia), diabetes mellitus or intra uterine growth retardation and were admitted as high risk pregnancies to AL-Zahra hospital. The study population routinely underwent sonographic evaluation of cerebral and umbilical arteries and a biophysical profile twice a week until the end of pregnancy. "nResults: Infants who had a lower score of biophysical profile, had a lower umbilical PH and a negative base deficit. Fetuses with a lower MCA/Umb. A RI had a higher base deficit and acidosis (measured from umbilical blood) after birth. Apgar on minute 5 was higher in infants with a history of higher profile score as well as a higher MCA/Umb. A. RI ratio. On the other hand; there was no significant correlation between MCA RI and umbilical PH. Correlation between Umb. A. RI and umbilical PH was not significant either. "nConclusion: Biophysical profile and assessment of the umbilical and cerebral arteries are valuable modalities for predicting the fetal condition and the outcome in high risk pregnancies. MCA/Umb. A RI Index ratio is a better indicator compared to its components.
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