Objectives: In a high risk population where chances of adverse outcome are relatively high and almost all the pregnancies are under strict monitoring, biophysical profiling further helps to identify adverse outcome and thus a basis for intervention. In this study, we aim to evaluate the role of modified biophysical profile in high risk pregnancies and fetal outcome. Methods: Total 125 high risk pregnancies and were monitored for modified biophysical profiling from GA 34 weeks onwards. AFI<8 and non-reactive NST were considered as abnormal BPP. Apgar <7 at 5 min, MSL, NNU admission and neonatal death were considered as adverse fetal outcomes. Chi-square test was used to compare the data. Results: Mean age was 24.32±4.37 (range 19-35) years. Mean age at enrolment was 35.23±1.78 weeks. A total of 41 (32.8%) patients had AFI<8.  Non-reactive NST was seen in 52 (41.6%) patients. Overall abnormal biophysical profile (NR-NST/AFI<8) was seen in 62 (49.6%) patients. Incidence of meconium stained liquor, Apgar<7 at 5m, NNU admission and NNU expiry was 15.2%, 20.8%, 26.4% and 4.0% respectively. NST and overall BPP showed a statistically significant association with all the outcomes however, AFI failed to show a significant association with NNU expiry. For all the outcomes NST had higher sensitivity as compared to AFI. Combined BPP showed a higher sensitivity than either of two components. Conclusion: Modified BPP was found to be useful in identification of adverse fetal outcomes, thus highlighting its role in planning interventions to avert extreme events. Keywords:

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