Aysha Afzal, Khalida Nasreen.
Biophysical score; high risk pregnancy.
Professional Med J Jan ;13(3):362-9.

A pregnancy is defined as high risk when there is a likelihood of an adverse outcome to the woman and or her baby that is greater than the incidence of that outcome in the general pregnant population. Objectives: To determine the efficacy and predictive value of biophysical profile in detecting perinatal outcome. Design: Observational study. Setting: Obstetrics and Gynaecology department, PNS SHIFA Karachi Period: From February 2003 to October 2003. Patients and Methods: The study was carried on 100 randomly selected high risk pregnant patients who reported to gynae OPD or were referred from different armed forces hospitals from all over sindh . Manning`s biophysical profile excluding nonstress test and including only ultrasound based parameters were employed for fetal screening ( BPS 8/8). These parameters include four variables i.e fetal breathing movement, fetal tone, fetal movements, and amniotic fluid volume. Nonstress test and Doppler studies were used as backup tests where biophysical profile was abnormal. All cases selected were admitted in the hospital and each had an admission biophysical profile followed by subsequent monitoring. Parameters for abnormal perinatal outcome include fetal distress in labour, five minute apgar score less than 7/10, admission of newborn to intensive care unit and stillbirth or neonatal death. The result of last biophysical profile is compared with perinatal outcome. For statistical analysis the predictive value, specificity and sensitivity are used to determine the ability of biophysical profile to predict an abnormal perinatal outcome. Results: Out of 100 cases 92 had a normal biophysical profile in the last scan of 8/8. 90 cases had a normal perinatal outcome with A/S > 7/10. In two cases A/S at 1 and 5 minute is < 7/10 with one baby shifted to nursery for delayed cry. 08 cases had an abnormal biophysical profile with scores of 4/8 and 2/8. There was one false positive who showed abnormal biophysical profile but baby was born with an A/S of 8/10 at 05 minutes. There was no neonatal death in this study group. The sensitivity of biophysical profile was 77.7%, specificity 98.90%. predictive value for a positive test was 87.5%, predictive value for a negative test was 97.8%. Conclusion: Biophysical profile is highly accurate and reliable test of diagnosing fetal status.

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