A SIMPLIFIED FETAL BIOPHYSICAL PROFILE

Objective: To modify the classic fetal biophysical profile (FBP) with the aim of obtaining rapid and accurate information about actual fetal condition in non-compromised fetuses with a subsequent favorable outc ome and to be suitable for a number of outclinic patients. Methods: Fo ur-hundred and ninety-four fetuses from singleton pregnancies in two r andomized groups were monitored by the modified FBP (mFBP) and 168 of them after the external vibratory acoustic stimulation (VAS/mFBP). The mFBP was characterized by two main characteristics: non-stress test w as excluded and the testing was finished at the moment when all of the three fetal biophysical activities became normal. The external VAS wa s applied only in cases with no evidence of fetal activity at the star t of the FBP. Results: Of the examined fetuses, 326 fetuses in the con trol group were monitored by the mFBP and there were 316 (96.9%) favor able outcomes and 10 (3.1%) adverse perinatal outcomes. The sensitivit y, specificity and positive and negative predictive values of the mFBP score in predicting adverse perinatal outcome were 60, 99, 66.7 and 9 8.7%, respectively. In the study group of 168 fetuses there were 165 ( 98.2%) favorable outcomes and three (1.8%) adverse perinatal outcomes. The sensitivity, specificity and positive and negative predictive val ues of the VAS/mFBP were 66.7, 100, 100 and 99.4%, respectively. The e fficiency of the VAS/mFBP in predicting perinatal mortality alone was even higher. After the external VAS and the first 5 min of the modifie d testing approximately two-fifths (41.8%) of healthy fetuses with a s ubsequent good outcome exhibited normal in all of the three biophysica l activities and approximately two-thirds (65.5%) of them after 10 min . In the VAS/mFBP group of healthy fetuses, during the same time perio ds, normal breathing movements were observed in 72% and 87% of fetuses , respectively. Conclusions: According to our results the mFBP and par ticularly the VAS/mFBP antenatal protocol as a new and rational varian t of the FBP could improve fetal assessment allowing in cases of non-c ompromised fetuses rapid and accurate information about actual fetal w ell-being. Because of its high accuracy and a reduced testing time the antepartal method with observation of fetal breathing movements after VAS is becoming acceptable as a screening of fetal well-being evaluat ion in outclinic conditions. (C) 1998 International Federation of Gyne cology and Obstetrics.