Ghazala Mahmud, Nasira Tasnim, Amina Qazi.
Admission Biophysical Profile: A better predictor of perinatal outcome.
J Surg Jan ;19-20:6-11.

The objective of the study was to see whether intrapartum admission Biophysical Profile is a better predictor of perinatal outcome than electronic fetal heart rate monitoring alone. Medical records of all low risk laboring women with singleton pregnancies of 34weeks or more gestation were analyzed .The diagnostic value of the intrapartum admission Biophysical Profile (BPP) was compared with elctronic fetal heart rate monitoring. Out of 620 women, 592 (95.5%) had normal admission BPP, while 28 (4.5%) had an abnormal test result. The incidence of neonatal morbidity was 75% in abnormal test group and 0.3% in normal group. The sensitivity, specificity, positive and negative predictive values in terms of neonatal morbidity were 87%, 98 %, 75% and 99.5%respectively. Out of the same study group, CTG was found reactive in 534 (86%) cases and non-reactive in 86(14%) cases. Incidence of neonatal morbidity was 11.6% in non-reactive group and 2.6% among reactive group. The sensitivity, specificity, positive and negative predictive values of CTG in terms of neonatal morbidity were 42%, 88%, 12%and 97% respectively. Two neonatal deaths occurred in the study population (corrected perinatal mortality rate 4/1000). Both had an abnormal BPP, however, admission CTG was non-reactive in only one fetus. Intrapartum biophysical profile is a simple non invasive screening test with high clinical efficacy that helps to identify a group of fetuses from low risk laboring women, who might benefit from more intensive monitoring and possibly from expeditious delivery. The test is a better predictor of perinatal outcome than electronic fetal heart rate monitoring alone.

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