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The modified biophysical profile: antepartum testing in the 1990s
D A Miller1, Y A Rabello, R H Paul
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Los Angeles County and University of Southern California Women's and Children's Hospital, CA 90033, USA.
American Journal of Obstetrics and Gynecology
|March 1, 1996
Summary
The modified biophysical profile offers a low false-negative rate for antepartum testing, reducing the risk of missed fetal distress. However, false positives can lead to iatrogenic prematurity in 1.5% of cases before 37 weeks.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Fetal Monitoring
Background:
- Antepartum testing is crucial for fetal well-being assessment.
- The modified biophysical profile (MBP) is a common antepartum surveillance tool.
- Understanding the accuracy of MBP is essential for clinical decision-making.
Purpose of the Study:
- To evaluate the false-negative and false-positive rates of the modified biophysical profile.
- To compare the MBP's accuracy with other antepartum testing methods.
Main Methods:
- Prospective collection of antepartum testing results from 1990-1994.
- Detailed intrapartum and neonatal data collection for women with abnormal MBP results in 1991.
Main Results:
- The false-negative rate of the MBP antepartum testing protocol was 0.8 per 1000 women.
- Sixty percent of deliveries due to abnormal MBP showed no signs of fetal compromise.
- False-positive MBP results led to preterm delivery in 1.5% of women tested before term.
Conclusions:
- The modified biophysical profile demonstrates a lower false-negative rate compared to the nonstress test.
- MBP's false-negative rate is comparable to the contraction stress test and complete biophysical profile.
- Iatrogenic prematurity occurred in 1.5% of women due to interventions for false-positive MBP results before 37 weeks gestation.