Computer-assisted assessment of the fetal biophysical profile

Abstract

The biophysical profile assesses (1) fetal heart rate, (2) breathing movements, (3) fetal body movements, (4) amniotic fluid volume, and (5) fetal tone. In the past, these data have been scored by an arbitrary, unweighted system. While this approach is useful in detecting major anomalies and oligohydramnios, both static observations, the dynamic variables (fetal heart rate, fetal breathing movements, and fetal body movements) have added little information beyond that of an extended nonstress test alone. We have evaluated an alternative biophysical assessment system, modeled after extended physiologic studies, which not only acquires dynamic fetal variables simultaneously but, with computer assistance, quantifies the biophysical information. With an ADR 4000/L- scanner, a Hewlett-Packard 8040 A monitor, and a specially programmed IBM microcomputer, we studied 100 normal term fetuses during 60-minute epochs. Each gestation had normal amniotic fluid volume and fetal tone. Normative values for the dynamic variables, expressed as means ± SD were: (1) fetal heart rate, 137 ± 6.3 bpm; (2) incidence of fetal breathing movements, 25.0% ± 17.3%; (3) rate of fetal breathing movements, 46.0 ± 9.4 breaths/min; (4) total fetal breathing movements, 823 ± 61; (5) incidence of fetal body movements, 8.5% ± 3.9%; (6) accelerations (>15 bpm, 15 seconds), 14.1 ± 6.3. We conclude that this approach is practicable, respects the biologic cycles of fetal behavior, and provides a basis for population standards and sequential study of the same fetus.