Document Detail


Is the intrapartum biophysical profile useful?
MedLine Citation:
PMID:  12962926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the role of biophysical profile (BPP) during normal labor. The secondary goal was to assess the effect of oxytocics, regional anesthesia, and ruptured membranes on fetal behavior during labor. METHODS: The BPP (according to the Manning criteria) was performed prospectively in 100 normal, singleton pregnancies in active labor. To evaluate its role in the prediction of cesarean delivery and admission to the neonatal intensive care unit (NICU), statistical analysis included chi2 and Fisher exact tests for frequency analyses and t tests for comparisons of continuous data. RESULTS: At the mean cervical dilatation of 5.2+/-1.4 cm, 73 women had a BPP score of at least 8/10, 16 had 6/10, six had 4/10, and five had 2/10. The BPP was not influenced by use of oxytocics, prostaglandins, or epidural anesthesia. Fetal breathing (95% versus 71%; P=.002) and gross fetal movements (98% versus 84%; P=.04) decreased with rupture of amniotic membranes. A BPP score of 6/10 or less in labor was associated with a relative risk (RR) for cesarean delivery of 8.00 (95% confidence interval [CI] 2.4, 26.5). Cessation of any ultrasound component of BPP significantly increased the risk of cesarean delivery and admission to the (NICU) (RR=29; 95% CI 2.73, 308.66). In the multivariable analysis, however, fetal movements and amniotic fluid volume were most important in predicting the need for cesarean delivery. CONCLUSION: Fetal heart rate monitoring alone did not predict the need for cesarean delivery or neonatal outcome, whereas the BPP did. Biophysical profile could prove to be a clinically useful adjunctive tool in the assessment of fetal well-being in labor.
Authors:
So Young Kim; Meena Khandelwal; John P Gaughan; Mehmet H Agar; E Albert Reece
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-09     Completed Date:  2003-10-15     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  471-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section*
Confidence Intervals
Embryonic and Fetal Development / physiology*
Female
Fetal Distress / diagnosis*
Fetal Monitoring / methods*
Fetal Movement / physiology
Gestational Age
Heart Rate, Fetal
Humans
Infant Mortality / trends*
Infant, Newborn
Labor Onset
Multivariate Analysis
Obstetric Labor Complications / diagnosis*,  mortality,  surgery
Odds Ratio
Parity
Predictive Value of Tests
Pregnancy
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Ultrasonography, Prenatal
Comments/Corrections
Comment In:
Obstet Gynecol. 2004 Feb;103(2):400; author reply 400   [PMID:  14754716 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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