Advertisement

Antepartum fetal evaluation: Development of a fetal biophysical profile

  • Frank A. Manning
    Correspondence
    Reprint requests: Dr. Frank A. Manning, Department of Obstetrics and Gynecology, University of Manitoba, 770 Bannatyne Ave., Winnipeg, Manitoba, Canada R3E OW3
    Affiliations
    Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Southern California School of Medicine Los Angeles, California, USA

    Women's Hospital, Los Angeles County-University of Southern California Medical Center Los Angeles, California, USA
    Search for articles by this author
  • Lawrence D. Platt
    Affiliations
    Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Southern California School of Medicine Los Angeles, California, USA

    Women's Hospital, Los Angeles County-University of Southern California Medical Center Los Angeles, California, USA
    Search for articles by this author
  • Louise Sipos
    Affiliations
    Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Southern California School of Medicine Los Angeles, California, USA

    Women's Hospital, Los Angeles County-University of Southern California Medical Center Los Angeles, California, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Five fetal biophysical variables, fetal breathing movements, fetal movements, fetal tone, qualitative amniotic fluid volume, and the nonstress test, were measured in the same observation period in 216 patients with high-risk pregnancies. All delivered within one week of the last observation. The relationship between individual biophysical variables and combinations of variables to the outcome of pregnancy as judged by five-minute Apgar score, fetal distress in labor, and perinatal mortality rate (PMN) was determined. For any single test, the false negative rate was low and was similar between tests, but the false positive rate was high (>50%) and varied significantly between tests. Combining tests resulted in a significant change in both the false negative and false positive rates as compared to any single test. The most accurate differentiation of the normal from the compromised fetus was obtained when all five variables were studied. The PNM ranged from 0 when all variables were normal to 600 per 1,000 when all were abnormal. These data suggest that combined fetal biophysical testing is a more accurate method of antepartum fetal evaluation than any single method.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Martin Jr., C.B.
        • Schifrin B.S.
        Prenatal fetal monitoring.
        in: Aladjen S. Brown A.K. Perinatal Intensive Care. The C. V. Mosby Company, St. Louis1976
        • Evertson L.R.
        • Gauthier R.J.
        • Schifrin B.S.
        • Paul R.H.
        Antepartum fetal heart rate testing. I. Evolution of the nonstress test.
        Am. J. Obstet. Gynecol. 1979; 133: 29
        • Ray M.
        • Freeman R.
        • Pine S.
        • Hesselgesser R.
        Clinical experience with the oxytocin challenge test.
        Am. J. Obstet. Gynecol. 1972; 114: 1
        • Gauthier R.J.
        • Evertson L.R.
        • Paul R.H.
        Antepartum fetal heart rate testing: Intrapartum fetal heart rate observation and neonatal outcome following a positive contraction stress test.
        Am. J. Obstet. Gynecol. 1979; 133: 34
        • Christie G.B.
        • Cudmore D.W.
        The oxytocin challenge test.
        Am. J. Obstet. Gynecol. 1974; 118: 327
        • Schifrin B.S.
        • Lapidus M.
        • Doctor G.
        • Leviton A.
        Contraction stress test for antepartum evaluation.
        Obstet. Gynecol. 1975; 45: 433
        • Platt L.D.
        • Manning F.A.
        • LeMay M.
        • Sipos L.
        Human fetal breathing movements: Relationship to fetal condition.
        Am. J. Obstet. Gynecol. 1978; 132: 514
        • Manning F.A.
        • Platt L.D.
        • Sipos L.
        • Keegan Jr., K.A.
        Fetal breathing movements and the nonstress test in high-risk pregnancies.
        Am. J. Obstet. Gynecol. 1979; 135: 511
        • Manning F.A.
        • Platt L.D.
        Fetal breathing movements and the abnormal contraction stress test.
        Am. J. Obstet. Gynecol. 1979; 133: 590
        • Manning F.A.
        • Platt L.D.
        Monitoring the fetus using fetal breathing movements.
        Clin. Obstet. Gynaecol. 1979; 6: 335
        • Manning F.A.
        • Platt L.D.
        Qualitative assessment of amniotic fluid volume—a rapid screen for IUGR (abst.).
        in: Proceedings of Society for Gynecologic Investigation, San Diego1979
        • Patrick J.E.
        • Featherson W.
        • Vick H.
        • Voegelin R.
        Human fetal breathing movements and gross body movements at weeks 34–35 of gestation.
        Am. J. Obstet. Gynecol. 1978; 130: 693
      1. Platt, L. D., Manning, F. A., Hill, L. M., and Sipos, L.: Unpublished observation).

      2. Mason, J. R., Murata, Y., Socol, M., and Manning, F. A.: Unpublished observation.

        • Boddy K.
        • Dawes G.S.
        Fetal breathing.
        Br. Med. Bull. 1975; 31: 3
        • Manning F.A.
        • Platt L.D.
        Human fetal breathing movements and maternal hypoxemia.
        Obstet. Gynecol. 1979; 53: 758
        • Manning F.A.
        • Feyerabend C.
        Cigarette smoking and fetal breathing movements.
        Br. J. Obstet. Gynaecol. 1976; 83: 262
        • Manning F.A.
        • Walker D.
        • Feyerabend C.
        The effect of nicotine on fetal breathing movements in conscious pregnant ewes.
        Obstet. Gynecol. 1978; 52: 563
      3. Manning, F. A., and Socol, M.: Unpublished observation.

        • Campbell S.
        • Wladimiroff S.W.
        • Dewhurst C.J.
        The antenatal measurement of fetal urine production.
        Br. J. Obstet. Gynaecol. 1973; 80: 680