BIOPHYSICAL SCORE

HIGH RISK PREGNANCY

Abstract

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.