Biophysical fetal assessment--the Rotunda experience

Biophysical profile score in late pregnancy and timing of delivery

OBJECTIVE

To determine if the Biophysical Profile Score (BPS) as a screening procedure on patients without antenatal care (unbooked patients), seen in late pregnancy, is of value in providing an insight into the mode of delivery and fetal outcome.

DESIGN

Prospective case study of pregnant mothers, data collection and analysis over 2 years at Abha Maternity Hospital, Saudi Arabia.

SUBJECTS

Unbooked patients with abnormal BPS (Group I), and patients with normal BPS (Group II) used as control subjects, delivered in the hospital from January 1996 through December 1997.

RESULTS

The number of normal deliveries was significantly higher (P < 0.01) in the control group than in the study group patients. Cesarean section rate was significantly higher in the study group than in the control group (P < 0.01, OR = 4.48). There was a significant increase in the number of asphyxiated and meconium aspirated babies in the study group than in the control group. Neonates that needed mechanical ventilation were significantly higher in the study group than in the control group (P < 0.01, OR = 10.38).

CONCLUSION

These findings suggest that abnormal BPS is invaluable in effecting delivery, particularly in women without antenatal care, who present in late pregnancy to an obstetric unit. Patients with abnormal BPS are four times more likely to be delivered by cesarean section than those with normal BPS.

Perinatal mortality at the North West Armed Forces Hospital, Tabuk, Saudi Arabia and the potential benefits of the biophysical profile score

Relatively little information is available in the literature regarding perinatal mortality in Saudi Arabia and none concerning the value of a full fetal assessment screening program in its reduction. This study analyzes all deliveries with a birth weight of greater than 500 grams at the North West Armed Forces Hospital (NWAFH) for the year 1992. It investigates the causes of perinatal death, ascertaining those which could potentially have been avoided and assessing the role which a fetal assessment screening program might have played in its reduction. There were 4387 babies born during this period. The combined perinatal mortality rate was 16.3%. Of these, 6.5% comprised babies weighing less than 1000 grams. Fifty-one (71%) of the deaths occurred among high risk patients and of these, 28 might have been saved had they been referred for fetal assessment screening. This study shows that the perinatal mortality rate at the NWAFH is comparable to figures obtained in other major centers in the country and that the introduction of a fetal assessment screening program could potentially result in a decrease in the perinatal mortality rate to less than 10/1000.