COMPARISON OF THE MODIFIED BIOPHYSICAL PROFILE TO A NEW BIOPHYSICAL PROFILE INCORPORATING THE MIDDLE CEREBRAL-ARTERY TO UMBILICAL ARTERY VELOCITY FLOW SYSTOLIC DIASTOLIC RATIO/

OBJECTIVES: The objective of this study was to determine whether the a ddition of the middle cerebral to umbilical artery systolic/diastolic velocity waveform ratio to the modified biophysical profile would impr ove perinatal outcome in patients at high risk. STUDY DESIGN: A prospe ctive, randomized outcome study of patients referred to the perinatal laboratory for antenatal surveillance was undertaken. Six hundred sixt y-five patients were randomized to two antenatal surveillance protocol s: group 1, modified biophysical profile; and group 2, modified biophy sical profile plus evaluation of the middle cerebral artery to umbilic al artery systolic/diastolic ratio. Patients were followed up serially and neonatal outcome data including gestational age at delivery, birt h weight, incidence of cesarean section delivery for fetal distress, a dmission to the neonatal intensive care unit, days in the neonatal int ensive care unit, and the presence of significant neonatal morbidity w ere tabulated. RESULTS: The total population showed no statistical dif ference in outcome parameters between groups 1 and 2. However, a subgr oup of patients evaluated for suspected uteroplacental insufficiency d id show a significant reduction in caesarean section for fetal distres s in group 2 patients. CONCLUSIONS: In a subgroup of patients at risk for uteroplacental insufficiency, the addition of the middle cerebral/ umbilical artery ratio to an antenatal surveillance protocol should be expected to improve perinatal outcome.