Applicability of the Rapid Biophysical Profile in Antepartum Fetal Well-Being Assessment in High-Risk Pregnancies from a University Hospital in S？o Paulo, Brazil: Preliminary Results

Objective. To evaluate the clinical applicability of the rapid biophysical profile (rBPP), comparing results of the rBPP to umbilical cord pH values and Apgar scores. Methods. A cross-sectional study was conducted with 37 pregnant women from our high-risk service. All of them gave birth at our institution. rBPP was conducted up to 24？h prior to delivery and pH values were obtained from the umbilical vein immediately after birth. The mean and standard deviations for maternal age, gestational age at birth, pH values, and Apgar score in the 1st and 5th minutes after birth were calculated. An unpaired Student’s -test was applied to evaluate the correlation between these variables and rBPP scores of 2 and 4. Results. rBPP score of 2 was observed in 8 patients (21.6%) and score 4 was observed in 29 cases (78.4%). No patients received score zero. The difference between the Apgar scores of the rBPP score 2 and 4 was statistically significant ( ) while the same was not true with the umbilical cord pH ( ), even though the values tended to be lower in the rBPP 2 group. Conclusion. The rBPP is a fast and practical method of assessment of antepartum fetal well-being. Further studies, with a larger number of patients, are necessary to evaluate the applicability of the method. 1. Introduction Various methods of evaluation of fetal vitality in high-risk pregnancies have been proposed in the past 30 years [1–3]. Among them is the fetal biophysical profile (FBP), proposed by Manning et al. [4] in 1980, which has stood out. It consists of the evaluation of 4 ultrasonographic criteria, 3 acute (fetal breathing movements, generalized fetal movements, and fetal tone), and one chronic (amniotic fluid index-AFI), and one cardiotocographic criterion (transient accelerations in response to fetal movements). Each criterion is given a score of 0 or 2 and the sum of all criteria yields the result. Scores of 8 and 10 are considered normal. In a study of 12,620 high-risk pregnancies, the perinatal mortality rate for normal values (≥8) was 0.652/1,000, while, for null scores, the mortality rate was 187/1,000. Therefore, the BPP is an effective method for antepartum assessment of fetal well-being in high-risk pregnancies, but its applicability in the overcrowded and underfunded hospital is limited: a trained fetal sonographer, ultrasound apparatus, and a cardiotocographer are required to carry out the test, in addition to up to 30 minutes for the procedure to be accurately performed. The rapid biophysical profile (rBPP), proposed by Tongsong et al. [5], consists of the measurement of