Fetal biophysical profile and perinatal death

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Perinatology

Background:

• High-risk pregnancies require effective antepartum surveillance to mitigate perinatal mortality.
• Accurate prediction of perinatal death is essential for timely intervention.

Purpose of the Study:

• To evaluate the predictive accuracy of individual biophysical variables and the combined biophysical profile score for perinatal death.
• To assess the performance of the biophysical profile score in predicting different causes of perinatal mortality.

Main Methods:

• A prospective study of 5034 high-risk pregnancies.
• Assessment of five biophysical variables: nonstress test, fetal breathing movements, fetal movements, fetal tone, and amniotic fluid volume.
• Calculation of likelihood ratios to express predictive ability for perinatal death.

Main Results:

• Fetal movement (LR 48.1) and the biophysical profile score (LR 51.0) demonstrated the highest predictive accuracy for perinatal death.
• The biophysical profile score was more effective in predicting death due to asphyxia than lethal anomalies.
• Perinatal mortality rates varied significantly with biophysical profile score: 1.0/1000 for normal, 31.3/1000 for equivocal, and 200.0/1000 for abnormal scores.
• The false-negative rate for the biophysical profile score was 0.7 per 1000 births.

Conclusions:

• The biophysical profile score, particularly when incorporating fetal movement assessment, is a powerful tool for predicting perinatal death in high-risk pregnancies.
• Abnormal biophysical profile scores are strongly associated with increased perinatal mortality risk.
• This assessment aids in identifying fetuses at risk and optimizing management strategies.