EVALUATION OF BIOPHYSICAL FETAL ASSESSMENT IN HIGH-RISK PREGNANCY TO ASSESS ULTRASOUND PARAMETERS SUITABLE FOR SCREENING IN THE LOW-RISK POPULATION

During a 1-year period, 662 pregnant women at 24-43 weeks' gestation w ere referred to the Department of Obstetrics and Gynaecology, at the Q ueens University Belfast, for fetal assessment because they were clini cally suspected to be at high risk of perinatal complications. The res ults of our investigations were made available to the referring obstet ricians who undertook the further management of the pregnancies. Subse quently. six pregnancies resulted in perinatal deaths and 97 (14.7%) i n the delivery of small-for-gestational-age infants. We restrospective ly analyzed the data from ultrasonographic evaluation of the fetus and subjective and objective assessments of the amniotic fluid volume to determine their value in the prediction of adverse perinatal outcome. A fetal abdominal circumference < 10th centile for gestation or a subj ectively reduced amniotic fluid volume identified 87 (90%) of small-fo r-gestational-age infants and five of the six perinatal deaths. When c omparing the abdominal circumference and subjective liquor volume, bot h were sensitive in predicting delivery of a small-for-gestational-age fetus (sensitivity 86% vs. 53%, respectively) and perinatal death (se nsitivity 50% vs. 83%, respectively). We suggest that, since assessmen ts of these two factors are complementary in evaluating a high-risk pr egnancy and can be measured in under 5 min, they now warrant considera tion for screening in a prospective randomized trial in an unselected low-risk population.