Biophysical fetal assessment — The Rotunda experience

Abstract

The evaluation of fetal health using ultrasound to establish a biophysical profile in the Rotunda Hospital in 1987 is reported. The corrected perinatal mortality rate fell from 10.0 in 1986 to 6.9 per 1,000 for babies over 500g and from 5.9 in 1986 to 3.4 for babies over 1,000g. This was achieved without significant alteration in induction and caesarean section rates. The results indicate that this type of fetal assessment does lead to a reduction in perinatal mortality.

Perinatal Mortality at the North West Armed Forces Hospital, Tabuk, Saudi Arabia and the Potential Benefits of the Biophysical Profile Score

“…Deaths of unknown cause (23%) and placental insufficiency (15%) comprise the majority of those cases where increased fetal surveillance might potentially have been of value. It is interesting to note that 71% of the perinatal deaths fell into a high risk category 17 which might have ensured referral for BPS in over half of which cases it would potentially have been beneficial. However, modification of the standard indications for performing biophysical profiles are desirable in the Saudi context.…”

“…Fetal assessment based on biophysical score estimation has been in use for approximately 13 years since it was described by Manning 5 and its implementation has had a significant effect on PNM in those centers where it has been introduced. 17,19,20 The success of the introduction of a fetal assessment program can be judged by the reduction in perinatal mortality and morbidity which ensues. However, these are end-points in themselves and must be viewed in conjunction with the increased workload involved and the twin problems of patient inconvenience and compliance.…”

“…While there is unlikely to be any significant alteration in these rates, 17 there will hopefully be a shift in their composition, rendered possible by a more precise knowledge of fetal status and well-being.…”

“…The implementation of a large scale fetal assessment program as in 1987 at the Rotunda Hospital, Dublin, 17 which reduced the PNM from 10.0 to 6.9 for all babies born over 500 g, requires large scale investment in both personnel and equipment. The Rotunda experience shows that approximately one-third of patients fall into a high risk category suitable for referral for BPS and that these patients require an average of three scans each with a total scanning time per patient of about one hour.…”