A STUDY OF MODIFIED BIOPHYSICAL PROFILE IN PREDICTING NEONATAL OUTCOME IN HIGH-RISK PREGNANCIES AFTER 34 WEEKS OF GESTATION
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Keywords
BPP, NST, APGAR, Modified BPP, AFI
Abstract
BACKGROUND
It is a known fact that no health problem is more significance to a nation than maternal health and neonatal morbidity in India. The average neonatal mortality in India in a year is about 26 per 1000 live births. Various maternal complications such as eclampsia, anemia, oligohydramnios etc, are the major causes for neonatal loss. Such high risk pregnancies need to be identified so that appropriate surveillance and timely interventions can be employed and thus bring down the rate of neonatal morbidity and mortality1. The modified biophysical profile (MBPP) suggested by Nageotte et al2 combines non-stress test (NST) as a short term marker of fetal status and amniotic fluid index (AFI) as a marker of long term placental function is easier to perform and less time consuming than complete biophysical profile or contraction stress test. Also modified biophysical profile (MBPP) considered to be as effective as complete biophysical profile. Non Stress Test (NST): Freeman and Lee and colleagues (1975) introduced the non stress test (NST) to describe fetal heart rate acceleration in response to fetal movement as a sign of fetal health. Hence, the present study is undertaken for modified biophysical profile in predicting neonatal outcome in high risk pregnancies after 34 weeks of gestation.
METHODS
This study was conducted on 100 high risk pregnant patients of >34 weeks of gestation admitted to Basaveshwar teaching and general hospital & Sangameshwar teaching hospital. Detailed history followed by general and obstetric examination was done and the patients were subjected to modified BPP.
RESULTS
These high risk cases were evaluated antenatally with modified BPP and among them 50 cases had AFI > 5cm, had reactive NST and 50 cases had AFI < 5cm, had non reactive NST. 90 cases required LSCS & the majority of cases undergoing LSCS, indication was fetal distress & major risk factor associated with it was Pre eclampsia. Neonatal resuscitation and NICU admission was increased in abnormal modified biophysical profile group.
CONCLUSION
MBPP can be used as a method of antepartum fetal surveillance test to predict neonatal outcome and provide timely intervention in a short time. Its a very cost effective and efficient tool of antenatal fetal surveillance.
References
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Dr. Kishwar Jahan
Post Graduate 3rd year, Department of Obstetrics and Gynaecology, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India.
Dr. Suman Umeshchandra
Professor, Department of Obstetrics and Gynaecology, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India.
Meenakshi D.
Professor and HOD, Department of Obstetrics and Gynaecology, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India.