Diagnostic Value of Rapid Biophysical Profile in Comparison to Biophysical Profile in Pregnant Women with Insulin-dependent Diabetes

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.

Comparing four modalities of fetal assessment and their impact on perinatal outcome in cases of asymmetrical IUGR

“…Accorddingly, the sensitivity and specificity of rBPP were 56.2% and 90.5% respectively. Researchers concluded that rBPP method compared to MBPP has a better capacity to discriminate non-distressed fetuses from distressexposed fetuses and they recommended its use as a quick and easy method in crowded centers with limited evaluation tests [24] .…”

Fetomaternal Outcomes of Low-Risk Females Presenting with Perceived Reduced Fetal Movements at Moi Teaching and Referral Hospital, Eldoret, Kenya

“…3 In that study, the authors noted that intrauterine death was preceded by reduction in perception of fetal movements in the previous 3-4 days, followed by complete cessation of perception of the movements 12-48 hours before eventual fetal demise. 3 Soufizadeh et al 4 also reported that while RFM was a predictor of adverse fetal outcomes, perception of normal movements is especially useful to the mother as it allays fears of imminent fetal death. For the obstetrician, it offers assurance of good fetal wellbeing in case postponement of delivery is needed to allow for lung maturity.…”

“…For the obstetrician, it offers assurance of good fetal wellbeing in case postponement of delivery is needed to allow for lung maturity. 4 For the expectant female, RFM is a major cause of concern. Consequently, reduced fetal movements have been shown to be a major indication for hospitalisation, at the detriment of overwhelming the facilities, and crucially, especially in the third world, the already low numbers of the healthcare workers.…”