scholarly journals Modified biophysical profile and perinatal outcome in high risk pregnancies

Author(s):  
Gulafshan Anjum ◽  
Hina Mittal ◽  
Nidhi Chauhan

Background: Aim and objective of current investigation was to evaluate perinatal outcome in high risk pregnancy with modified biophysical profile and also evaluate the efficacy of MBPP.Methods: Type of study was observational study, 100 patient fulfilling inclusion criteria were included in study. All women were subjected to modified biophysical profile comprises amniotic fluid index and non stress test. NST was performed with cardiotocogram, real time ultrasound scanning was performed. Perinatal outcome assessed in terms of admission to NICU, low birth weight, foetal distress, low APGAR score, neonatal mortality.Results: Out of 100 cases, 55 cases had reactive NST and 45 had non reactive NST. AFI was normal in 79 cases 21 cases had abnormal AFI. Diagnostic power was maximum seen with NST i.e. 76.36% (61.90% for AFI and 71.64% for combined MBPP) it indicates that NST is a good predictor to diagnose a compromised foetus.Conclusions: This study shows that pregnancy with high risk factors are associated with more chances of intrapartum complications perinatal morbidity and mortality , if MBPP was abnormal or any one parameter was abnormal, chances of perinatal morbidity were high.

Author(s):  
K. P. Sowmya ◽  
S. R. Mudanur ◽  
Padmasri R. ◽  
Lalitha S.

Background: Fetal biophysical profile is a well-established method of antepartum surveillance in high risk pregnancy. Classical biophysical profile with all parameters (fetal breathing movements, fetal tone, fetal gross body movements, amniotic fluid volume and non-stress test) needs two phase testing by ultrasound and external Doppler monitor to record fetal heart rate, is more cumbersome, time consuming and expensive.Methods: This study was a prospective clinical study which consisted of 70 patients having pregnancy with high risk factors. The patients were evaluated with the modified biophysical profile consisting of NST recording for 20mins, followed ultrasound assessment of amniotic fluid volume, using four quadrant technique.Results: When the Modified biophysical profile is normal, it gives reassurance that the fetal status is good with good perinatal outcome. When the MBPP is abnormal there is increased incidence of perinatal morbidity as well as mortality.Conclusions: Modified biophysical profile is an effective primary antepartum fetal surveillance test in high risk pregnancies in predicting perinatal outcome.


Author(s):  
Jankidevi S. Borade ◽  
Sushma P. Sharma

Background: The goal of antepartum fetal surveillance is early identification of the compromised fetus and timely intervention when the fetus is at risk, but still in an uncompromised state. Modified Biophysical Profile (MBPP) includes Amniotic Fluid Index (AFI) and non stress test (NST). AFI is a marker of long term placental function and NST is a marker of short term fetal condition. The aim of this study is to assess the role of Modified Biophysical Profile in high risk pregnancies and assess perinatal outcome and to study the impact of NST and AFI individually in high risk pregnancies.Methods: 100 ANC patients with high risk factors were evaluated with modified biophysical profile 37 week onwards with non stress test (NST) for 20 mins and amniotic fluid index (AFI) with 4 quadrant technique. High risk pregnancies include preeclampsia, IUGR, oligohydramnios, postdated pregnancy, etc. and various parameters were assessed to determine perinatal and maternal morbidity. All parameters were statistically analyzed.Results: The above study states that need for LSCS, intrapartum fetal distress, meconium stained liquor, APGAR score, need for neonatal resuscitation and perinatal morbidity were definitely higher in cases with abnormal MBPP.Conclusions: Thus MBPP is an easy, cost effective and time saving measure and hence can be used as a primary antepartum fetal surveillance test to predict perinatal outcome and provide timely intervention in high risk pregnancies.


2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.


Author(s):  
Suhail Iqbal ◽  
Mehak Ayub Malik ◽  
Heena Kaurani ◽  
Divya Chauhan

Background: Adequate amount of amniotic fluid was required for normal growth of fetus. Oligohydramnios or reduced amount of amniotic fluid is associated with adverse maternal and perinatal outcome due to increase in induced labour and operative deliveries. Idiopathic oligohydramnios is a condition in which no other risk factors are associated with pregnancy. This study was done to compare the effect of L-arginine and IV hydration on improvement of amniotic fluid index and fetal growth.Methods: Total 50 patients were included in the study according to inclusion criteria and divided equally into two groups randomly. IV hydration was given to one group and other group received L- arginine sachet orally. The effect on AFI and fetal outcome was compared.Result: The result was compared with respect to age, gravidity, gestational age and AFI at the time of study and after giving treatment. Maternal and fetal outcome was compared which shows that L-arginine was more effective in increasing the AFI and thereby leading to favorable results in the form of increase in gestational age at time of delivery and fetal weight.Conclusion: This study shows that both IV hydration and L-arginine are useful in treatment of oligohydramnios. But L-arginine appears more advantageous over IV hydration in improving pregnancy outcome and reducing perinatal morbidity and mortality.


2020 ◽  
Vol 18 (3) ◽  
pp. 401-405
Author(s):  
Santosh Jha ◽  
Ganesh Dangal

Background: High risk pregnant women have increased risk of maternal and neonatal morbidity and mortality. Antepartum surveillance is important and should be effective in such conditions. Modified biophysical profile is the method of antepartum surveillance which comprises of cardiotocography and amniotic fluid index. Methods: A cross-sectional study was carried out in Paropakar Maternity and Women’s Hospital from February 2019 to January 2020 to determine the effectiveness of modified biophysical profile. Cardiotocography was interpreted as reactive, equivocal and non-reactive. AFI was considered normal if it was 5 to 24 cm. In the study 172 high risk cases at term and not in labor were included. Each case was subjected to cardiotocography then amniotic fluid index was obtained using real time sonography where it was measured from all four quadrants. Modified biophysical results were obtained and then were divided into 2 arms as normal modified biophysical profile and abnormal modified biophysical profile then analysis was done. Results: Of 172 cases, there were 97 (56.4%) cases in normal modified biophysical profile and remaining 75 (43.6%) in abnormal modified biophysical profile group. The rate of cesarean section increased when there was abnormal modified biophysical profile.  Neonatal resuscitation and admission was increased in abnormal modified biophysical profile. Conclusions: Normal modified biophysical profile in high risk pregnancy had more cases of vaginal delivery and less adverse fetal outcome like low APGAR score, neonatal resuscitation and neonatal intensive care admission. Keywords: Amniotic fluid index; cardiotocography; fetal surveillance; modified biophysical profile


2012 ◽  
Vol 2 (8) ◽  
pp. 379-380
Author(s):  
Dr. Latika Mehta ◽  
◽  
Dr. Monark Vyas ◽  
Dr. Nilesh chauhan ◽  
Dr. Abhas Shah ◽  
...  

Author(s):  
Swathi Bhat ◽  
Ambika H. E. ◽  
Lepakshi B. G. ◽  
Savitha C. S.

Background: To evaluate whether oligohydramnios (AFI≤5) has any significance in the outcome of low risk pregnancies. Normal amniotic fluid index in pregnancy is one of the indicators of fetal well-being.  In a term pregnancy, oligohydramnios, a condition associated with AFI≤5, could be a sign of placental insufficiency. An association of low AFI with complications like pregnancy induced hypertension, consistently leads to poor fetal outcome. A need to deliver the fetus by cesarean section often arises. Occasionally one comes across a full-term pregnancy with AFI ≤5 with no known high risk factors; this could lead to increased cesarean section rates. Thus, it becomes necessary to evaluate if AFI ≤5 in the absence of other risk factors has any significance on obstetric outcome.Methods: Prospective case controlled study was done. Fifty women with term pregnancies and (AFI≤5) cm not associated with any other high risk factors were enrolled for the study. They were matched with fifty controls with normal AFI.Results: Except for a slight increase in variable deceleration in the study group, no differences were noted with fetal heart rate recordings in NST.  Decreased AFI was not associated with increased cesarean section rates, instrumental deliveries or meconium stained amniotic fluid. Severe asphyxia, NICU admission or perinatal mortality was not noted in either group.Conclusions: When a low risk pregnancy is associated with Oligohydramnios (AFI≤5), it does not have any deleterious effect on labor outcome or perinatal outcome.


Author(s):  
Urvashi . ◽  
Sujani B. K. ◽  
Krishna Sai Sushma

Background: The timely detection of morbid changes in the fetal status followed by adequate interventions to avoid death or disability is one of the most important objectives of prenatal care. Objective of present study was to Comparing the role of modified biophysical profile and the cerebroplacental ratio in fetal outcome in low risk and high risk pregnancies.Methods: Two hundred and seventy three singleton pregnant women were included in this study. Following routine examination, amniotic fluid index, pulsatility index of middle cerebral artery and pulsatility index of umbilical artery, uterine artery mean pulsatility index were evaluated. Non stress test (NST) was done. Modified biophysical profile (MBPP) and Cerebroplacental ratio (CPR in percentile) was generated. Caeserean section because of Fetal distress, birth weight <10th centile, 5min APGAR <7, NICU stay >24hours were used in evaluating the perinatal outcome.Results: Out of 273 cases, 107 cases had poor perinatal outcome. Out of 107 cases, 35.5% cases were IUGR, 39.2% cases underwent caesarean section in view of fetal distress, 39.2% babies had 5min APGAR <7 and 32.7% babies had stayed in NICU for >24hrs. In high risk cases, poor perinatal outcome was seen in 45.5% pregnancies and 36.7% in low risk pregnancies. Sixty seven percent of these cases had abnormal modified biophysical profile and only 7.4% cases had cerebroplacental ratio <1.Conclusions: Modified biophysical profile was proved to be more significant than cerebroplacental ratio in prediction of perinatal outcome. 


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