The biophysical profile as a tool for prediction of preterm delivery.

Abstract

Our objective was to determine if any of the following parameters is a predictor of preterm delivery: gestational age, cervical dilatation, or biophysical profile score.Sixty-two women with certain dates, intact membranes, and preterm contractions more frequent than 300 min underwent a 30-min ultrasonographic assessment of fetal breathing movements, fetal tone, fetal movement and amniotic fluid volume, each of which was scored as 0, 1, or 2 before any tocolytics were given. The total score (0-8) was calculated and cervical dilatation was recorded. All women were subsequently placed on tocolytics. Data were analyzed using survival analysis with stepwise regression of the covariates to determine the predictive values of the total score, its individual parameters, gestational age, and cervical dilatation to the outcome variable of hours to delivery. Gestational age, cervical dilatation and time interval to delivery were categorized and entered into a logistic regression model with the total score and its components to determine predictive odds.Total score (p < 0.0001) and cervical dilatation (p < 0.0001) were the most significant variables associated with time interval to delivery, followed by gestational age (p = 0.035). When the individual biophysical parameters were entered into the model, fetal tone (p < 0.0001), cervical dilatation (p < 0.0001) and gestational age (p < 0.014) were the only variables related to time interval to delivery. Predictive odds of delivery in less than 48 h in relation to fetal tone and cervical dilatation were calculated. Total score, fetal tone, and cervical dilatation were strongly associated with time interval to delivery. Our study did not support fetal breathing movements as a predictor of preterm delivery.