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Perinatal outcome with the modified biophysical profile

M P Nageotte¹, C V Towers, T Asrat

¹Long Beach Memorial Women's Hospital, CA 90801-1428.

American Journal of Obstetrics and Gynecology

|June 1, 1994

Summary

The modified biophysical profile effectively monitors high-risk pregnancies, identifying those needing extra care. It

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine
Neonatal Care

Background:

High-risk pregnancies require precise fetal surveillance to optimize perinatal outcomes.
The modified biophysical profile (mBP) combines nonstress tests and amniotic fluid index for antepartum fetal assessment.

Purpose of the Study:

To evaluate perinatal outcomes in high-risk pregnancies monitored with the modified biophysical profile.
To compare the efficacy of contraction stress tests (CST) versus biophysical profile (BPP) as backup tests for abnormal mBP.

Main Methods:

Prospective evaluation of 2774 non-insulin-dependent high-risk pregnancies undergoing biweekly modified biophysical profile testing.
Randomized backup testing (CST or BPP) for abnormal mBP results (nonreactive NST, decelerations, or AFI ≤ 5.0 cm).
Comparison of perinatal outcomes between patients with normal mBP, those requiring backup tests, and those randomized to CST vs. BPP.

Main Results:

The overall adverse perinatal outcome rate was 7.0%.
Patients requiring backup tests had significantly higher rates of adverse outcomes (9.3% vs. 4.9%) and small-for-gestational-age infants (5.2% vs. 2.4%) compared to those with normal mBP.
No significant difference in outcomes was found between CST and BPP as backup tests, though CST led to a higher intervention rate (23.7% vs. 16.6%).

Conclusions:

The modified biophysical profile is a valuable tool for fetal surveillance in high-risk pregnancies.
It effectively identifies fetuses at increased risk for adverse outcomes and small-for-gestational-age infants.
The biophysical profile is as effective as the contraction stress test as a backup, with a lower intervention rate.

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