Fetal biophysical profile Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2000;22(4):201-208
DOI 10.1590/S0100-72032000000400003
Purpose: to evaluate the modifications due to premature rupture of the membranes of variables of the fetal biophysical profile, comparing them to the ones found in pregnant women with intact membranes. In the group with premature rupture of the membranes, the association of biophysical variables with the Apgar score at the first and fifth minutes and with the occurrence or not of clinical chorioamnionitis and neonatal infection was analyzed. Patients and Methods: in a prospective study, 112 fetal biophysical profiles were established in 60 pregnant women with premature rupture of the membranes at a period between the 28th and the 40th week of pregnancy, and only the last fetal biophysical profile was analyzed and compared to other 60 fetal biophysical profiles of pregnant women with gestational ages identical to the group of study and with intact membranes. Results: statistical analysis of the results revealed that the premature rupture of the membranes diminished the reactivity, not interfering with the body movements of the fetus. It also diminished the frequency of the respiratory movements of the fetus, not determining modifications of the fetal tonus, and considerably decreasing the amniotic fluid index. In terms of prediction of chorioamnionitis and neonatal infection, the fetal biophysical profile did not show any significant statistic validity; however, when the biophysical variables were present, the correlation with the absence of chorioamnionitis and neonatal infection was clearly shown. The result of the last fetal biophysical profile was strongly associated with the Apgar score at the 5th minute. Conclusion: the fetal biophysical profile should be used routinely in pregnant women with premature rupture of the membranes with the purpose of evaluating fetal vitality, and in order to detect those fetuses at a higher risk of infection, specially those with gestational ages of less than 34 weeks. Regarding those fetuses it is best to use a conservative approach.
Summary
Rev Bras Ginecol Obstet. 2000;22(4):201-208
DOI 10.1590/S0100-72032000000400003
Purpose: to evaluate the modifications due to premature rupture of the membranes of variables of the fetal biophysical profile, comparing them to the ones found in pregnant women with intact membranes. In the group with premature rupture of the membranes, the association of biophysical variables with the Apgar score at the first and fifth minutes and with the occurrence or not of clinical chorioamnionitis and neonatal infection was analyzed. Patients and Methods: in a prospective study, 112 fetal biophysical profiles were established in 60 pregnant women with premature rupture of the membranes at a period between the 28th and the 40th week of pregnancy, and only the last fetal biophysical profile was analyzed and compared to other 60 fetal biophysical profiles of pregnant women with gestational ages identical to the group of study and with intact membranes. Results: statistical analysis of the results revealed that the premature rupture of the membranes diminished the reactivity, not interfering with the body movements of the fetus. It also diminished the frequency of the respiratory movements of the fetus, not determining modifications of the fetal tonus, and considerably decreasing the amniotic fluid index. In terms of prediction of chorioamnionitis and neonatal infection, the fetal biophysical profile did not show any significant statistic validity; however, when the biophysical variables were present, the correlation with the absence of chorioamnionitis and neonatal infection was clearly shown. The result of the last fetal biophysical profile was strongly associated with the Apgar score at the 5th minute. Conclusion: the fetal biophysical profile should be used routinely in pregnant women with premature rupture of the membranes with the purpose of evaluating fetal vitality, and in order to detect those fetuses at a higher risk of infection, specially those with gestational ages of less than 34 weeks. Regarding those fetuses it is best to use a conservative approach.
Summary
Rev Bras Ginecol Obstet. 2000;22(9):557-566
DOI 10.1590/S0100-72032000000900004
Purpose: to study the fetal well-being assessment in pregnancies complicated by diabetes, and to analyze the neonatal results. Methods: we studied 387 pregnant women with diabetes at the Fetal Surveillance Unit. The last examination (cardiotocography, fetal biophysical profile, amniotic fluid index and dopplervelocimetry) was correlated with the neonatal outcome. Results: the studied population included 46 (12%) type I diabetes, 45 (12%) type II and 296 (76%) gestational diabetes. Type I diabetes with abnormal or suspected cardiotocography was related to abnormal 1st minute Apgar (50 and 75%, p<0.05) and to the need for neonatal intensive care unit (50 and 75%, p<0.05). The abnormal biophysical profile in type II diabetic pregnancy was related to the need for neonatal intensive care (67%, p<0.05), and abnormal umbilical artery Doppler study was related to abnormal 1st minute Apgar (67%, p<0.05). Gestational diabetes with abnormal cardiotocography presented 36% abnormal 1st minute Apgar (p<0.05), 18% abnormal 5th minute Apgar (p<0.01) and 18% neonatal death (p<0.01). Abnormal amniotic fluid index was related to abnormal 5th minute Apgar (p<0.05) and need for neonatal intensive care unit (p<0.05). Gestational diabetes with abnormal umbilical artery Doppler was related (p<0.05) to: abnormal 1st and 5th minute Apgar, respectively, 25 and 8%, Need for neonatal intensive care in 17% and neonatal death in 8%. Conclusions: the fetal well-being examinations correlated with adverse perinatal outcome, showing the need for fetal surveillance in diabetic pregnant women.
Summary
Rev Bras Ginecol Obstet. 2000;22(9):557-566
DOI 10.1590/S0100-72032000000900004
Purpose: to study the fetal well-being assessment in pregnancies complicated by diabetes, and to analyze the neonatal results. Methods: we studied 387 pregnant women with diabetes at the Fetal Surveillance Unit. The last examination (cardiotocography, fetal biophysical profile, amniotic fluid index and dopplervelocimetry) was correlated with the neonatal outcome. Results: the studied population included 46 (12%) type I diabetes, 45 (12%) type II and 296 (76%) gestational diabetes. Type I diabetes with abnormal or suspected cardiotocography was related to abnormal 1st minute Apgar (50 and 75%, p<0.05) and to the need for neonatal intensive care unit (50 and 75%, p<0.05). The abnormal biophysical profile in type II diabetic pregnancy was related to the need for neonatal intensive care (67%, p<0.05), and abnormal umbilical artery Doppler study was related to abnormal 1st minute Apgar (67%, p<0.05). Gestational diabetes with abnormal cardiotocography presented 36% abnormal 1st minute Apgar (p<0.05), 18% abnormal 5th minute Apgar (p<0.01) and 18% neonatal death (p<0.01). Abnormal amniotic fluid index was related to abnormal 5th minute Apgar (p<0.05) and need for neonatal intensive care unit (p<0.05). Gestational diabetes with abnormal umbilical artery Doppler was related (p<0.05) to: abnormal 1st and 5th minute Apgar, respectively, 25 and 8%, Need for neonatal intensive care in 17% and neonatal death in 8%. Conclusions: the fetal well-being examinations correlated with adverse perinatal outcome, showing the need for fetal surveillance in diabetic pregnant women.
Summary
Rev Bras Ginecol Obstet. 2002;24(2):113-120
DOI 10.1590/S0100-72032002000200007
Purpose: to study fetal surveillance examinations in pregnancies complicated by pregestational diabetes mellitus, and to correlate them with large for gestational age (LGA) newborns. Methods: Between March 1999 and June 2001, 46 singleton pregnancies with pregestational diabetes mellitus without fetal anomalies were followed prospectively. From the 28th gestational week on, the following examinations were performed weekly: fetal biophysical profile, amniotic fluid index (AFI), and dopplervelocimetry of umbilical and middle cerebral arteries. The newborns with birthweight above the 90th percentile according to local standard values were characterized as LGA infants. Fisher's exact test and Student's t test were used for statistical analysis. Results: The mean gestational age at delivery was 37.6 weeks and 15 (32.6%) newborns were LGA. LGA fetuses showed significant increase in the AFI mean performed in the 32nd (16.5 cm, p=0.02), 33rd (16.7 cm, p=0.03), 34th (17.0 cm, p=0.02), 35th (17.9 cm, p=0.000), 36th (15.8 cm, p=0.03) and 37th (17.5 cm, p=0.003) weeks. Non-LGA fetuses presented the following mean AFI values: 13.5cm (32nd week), 13.1cm (33th week), 13.4 (34th week), 12.8 (35th week), 12.5 (36th week) and 12.8cm (37th week). AFI values equal to or above 18.0 cm were associated with the occurrence of LGA infants, when detected at the following gestational ages: 34th (60%, p=0.03), 35th (71.4%, p=0.01), 36th (80%, p=0.02) and 37th (66.7%, p=0.04) week. Non-LGA infants presented the following proportion of AFI values equal to or above 18.0 cm: 40.0% (34th week), 28.6% (35th week), 20.0% (36th week), and 33.3% (37th week). Conclusions: abnormal increase in AFI, mainly with values equal to or above 18.0 cm, is related to LGA infants at delivery. The maternal treatment should be adjusted to achieve the best result for maternal-fetal control, according to the AFI values during pregnancy.
Summary
Rev Bras Ginecol Obstet. 2002;24(2):113-120
DOI 10.1590/S0100-72032002000200007
Purpose: to study fetal surveillance examinations in pregnancies complicated by pregestational diabetes mellitus, and to correlate them with large for gestational age (LGA) newborns. Methods: Between March 1999 and June 2001, 46 singleton pregnancies with pregestational diabetes mellitus without fetal anomalies were followed prospectively. From the 28th gestational week on, the following examinations were performed weekly: fetal biophysical profile, amniotic fluid index (AFI), and dopplervelocimetry of umbilical and middle cerebral arteries. The newborns with birthweight above the 90th percentile according to local standard values were characterized as LGA infants. Fisher's exact test and Student's t test were used for statistical analysis. Results: The mean gestational age at delivery was 37.6 weeks and 15 (32.6%) newborns were LGA. LGA fetuses showed significant increase in the AFI mean performed in the 32nd (16.5 cm, p=0.02), 33rd (16.7 cm, p=0.03), 34th (17.0 cm, p=0.02), 35th (17.9 cm, p=0.000), 36th (15.8 cm, p=0.03) and 37th (17.5 cm, p=0.003) weeks. Non-LGA fetuses presented the following mean AFI values: 13.5cm (32nd week), 13.1cm (33th week), 13.4 (34th week), 12.8 (35th week), 12.5 (36th week) and 12.8cm (37th week). AFI values equal to or above 18.0 cm were associated with the occurrence of LGA infants, when detected at the following gestational ages: 34th (60%, p=0.03), 35th (71.4%, p=0.01), 36th (80%, p=0.02) and 37th (66.7%, p=0.04) week. Non-LGA infants presented the following proportion of AFI values equal to or above 18.0 cm: 40.0% (34th week), 28.6% (35th week), 20.0% (36th week), and 33.3% (37th week). Conclusions: abnormal increase in AFI, mainly with values equal to or above 18.0 cm, is related to LGA infants at delivery. The maternal treatment should be adjusted to achieve the best result for maternal-fetal control, according to the AFI values during pregnancy.
