Modified biophysical profile in the role of predicting fetal outcome in high risk pregnancies

Abstract

High risk pregnancies are these that result in maternal or fetal morbidity or mortality. These may include conditions such as pre-eclampsia, eclampsia, oligohydramnios, anemia. Therefore, it becomes very important for early identification of the risk so that immediate treatment can be given. In order to reduce the morbidity and mortality of both the mother and child. the non stress test and NST with the amniotic fluid volume (Modified biophysical profile) are some of the tests used for this purpose. : After the demographic details and clinical evaluation, Non stress test (NST) was done for all the patients. The fetal heart rate, movements and tone was measured along with the uterine contractions. If there were more than 2 fetal movements with two accelerations of 15 beats / minute or more within 10 mintues of monitoring, the test was rendered reactive. The amniotic fluid volume and Index were measured. The mean age of the women was 23.3 ± 5.1 years and the mean gestational age of them was 34.87 ± 3.91 weeks. The most predominant risk factors which was present in the expectant mothers was decreased movements of the fetus, followed by hypertension and Oligohydramnios. 27% of the patients had to be induced for vaginal delivery while spontaneous delivery was seen in 22% of the cases. 24% of the patients elected to go in for LSCS delivery while emergency LSCS was done on 14% of the patients. 68 (46.9%)mothers with high risk pregnancy had a normal NST and AFI, while 43 (29.7%) of them had an Abnormal NST with Abnormal AFI. 11 (7.6%) of them had Normal NST but an Abnormal AFI and 23 (15.9%) had and Abnormal NST with a Normal AFI. The overall sensitivity and the specificity of NST, AFI and MBPP are comparable to each other in the detection of fetal distress, though MBPP is marginally better.