Diagnostic Value of Rapid Biophysical Profile in Comparison to Biophysical Profile in Pregnant Women with Insulin-Dependent Diabetes
-
Nasrin Soufizadeh
,
Fariba Farhadifar
,
Saghar Tamri
,
Sara Behafarid
,
Karim Sharifi
,
Sima Aslani
,
Mobin Naqshbandi
Abstract
Objective: Having a rapid and low cost diagnostic approach in assessment of fetal wellbeing is an important goal for prenatal care process. The aim of this study was to determine the diagnostic value of rapid biophysical profile (rBPP) in comparison to biophysical profile (BPP).
Materials and methods: In this study 142 pregnant women with insulin-dependent diabetes referred to Besat Hospital (Sanandaj, Iran) were evaluated in terms of fetal health. Age, gestational age and non-stress test (NST) data of patients were collected. The fetuses were evaluated using the standard BPP and selected rBPP methods. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated. The receiver operating characteristic (ROC) curve was plotted. The data were analyzed in Stata 14 software, using appropriate statistical analyses.
Results: The mean ± standard deviation (SD) of maternal age and gestational age of the studied subjects were 30.6 ± 6.3 and 35.6 ± 1.5 weeks, respectively. The frequency of normal cases were
126 (88.7%) in the BPP method and 121 (85.2%) in the rBPP method. The results showed that sensitivity, specificity, PPV and NPV of rBPP in this study were 56.2%, 90.5%, 42.8% and 94.2%, respectively. The area under the ROC curve was 73.3%. Pearson Test showed a significant correlation between scores obtained through BPP and rBPP methods (p < 0.001).
Conclusion: Considering the high profile of the sensitivity and PPV of the RBPP method compared to BPP, rBPP method has a better capacity to discriminate non-distressed fetuses from distress-exposed fetuses. It can also be used as a quick and easy method in crowded centers with limited evaluation tests, where not much skill is needed.
2. Gibbs RS, Karlan BY, Haney AF, Nygaard IE. Danforth's obstetrics and gynecology. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.10th Ed.
3. Phattanachindakun B, Boonyagulsrirung T, Chanprapaph P. The correlation in antepartum fetal test between full fetal biophysical profile (FBP) and rapid biophysical profile (rBPP). J Med Assoc Thai.2010: 1;93:759-64.
4. Manning FA, Morrison I, Lange IR, Harman CR, Chamberlain PF. Fetal assessment based on fetal biophysical profile scoring: experience in 12,620 referred high-risk pregnancies: I. Perinatal mortality by frequency and etiology. Am J Obstet Gynecol 1985;151:343-50.
5. Manning F, Morrison I, Lange I, Harman C, Chamberlain P. Fetal biophysical profile scoring: selective use of the nonstress test. Am J Obstet Gynecol 1987;156:709-12.
6. Cunningham F, Leveno K, Bloom SL, Spong CY, Dashe JS,Hoftman BL,et al. Williams obstetrics. Mcgraw-hill; 2014.24th Edition.
7. Lalor JG, Fawole B, Alfirevic Z, Devane D. Biophysical profile for fetal assessment in high risk pregnancies. The Cochrane database of systematic reviews. Cochrane Database Syst Rev 2008; (1):CD000038.
8. Saraçoğlu F, Göl K, Şahin İ, Türkkanı B, Öztopçu C. The predictive value of fetal acoustic stimulation. J Perinatol 1999;19:103-5.
9. Gabbe SG, Niebyl J, Simpson L, Landon MB, Galan HL, Jauniaux ERM, et al. Obstetrics Normal and Problem Pregnancies.Acta Obstetricia et Gynecologica Scandinavica. 6th edn. Elsevier Saunders, Philadelphia, 2012.
10. Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR. Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver national institute of child health and human development, society for maternal-fetal medicine, and American college of obstetricians and gynecologists workshop. Obstet Gynecol 2012;120:1181-93.
11. Tracy SK, Hartz D, Hall B, Allen J, Forti A, Lainchbury A, White J, Welsh A, Tracy M, Kildea S. A randomised controlled trial of caseload midwifery care: M@ NGO (Midwives@ New Group practice Options). BMC pregnancy childbirth 2011;11:82.
12. Phattanachindakun B, Boonyagulsrirung T, Chanprapaph P. The correlation in antepartum fetal test between full fetal biophysical profile (FBP) and rapid biophysical profile (rBPP). J Med Assoc Thai 2010;93:759-64.
13. Voxman EG, Tran S, Wing DA. Low amniotic fluid index as a predictor of adverse perinatal outcome. J Perinatol 2002;22:282-5.
14. Manning FA. Antepartum fetal testing: a critical appraisal. Curr Opin Obstet Gynecol 2009;21:348-52.
15. Baschat A, Galan H, Bhide A, Berg C, Kush M, Oepkes D, et al. Doppler and biophysical assessment in growth restricted fetuses: distribution of test results. Ultrasound Obstet Gynecol2006;27:41-7.
16. Lotalizadeh M, Afiat M, Momeni M. Relation between modified biophysical profile and standard biophysical profile with neonatal outcome of high risk pregnancies. The Iranian Journal of Obstetrics, Gynecology and Infertility 2014;17:1-7.
17. Miller DA, Rabello YA, Paul RH. The modified biophysical profile: antepartum testing in the 1990s. Am J Obstet Gynecol 1996;174:812-7.
18. Niroomanesh S, Heidari A. Predictive accuracy of nonstress test in high risk pregnancies1. Tehran University Medical Journal2001;58:41-4.
19. Jamal A, Marsoosi V, Noori LE. A prospective trial of the fetal biophysical profile versus modified biophysical profile in the management of high risk pregnancies. Acta Medica Iranica 2007;45:204-8.
| Files | ||
| Issue | Vol 13, No 4 (December 2019) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v13i4.2648 | |
| Keywords | ||
| Rapid Biophysical Profile Biophysical Profile Embryo Health Pregnant Women Insulin-dependent Diabetes | ||
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