The biophysical profile and the nonstress test: poor predictors of chorioamnionitis and fetal infection in prolonged preterm premature rupture of membranes.
Sixty-eight women admitted with the diagnosis of preterm premature rupture of membranes (PROM) and a latency period of at least 48 hours were followed expectantly. Fetal surveillance consisted of daily kick counts, daily nonstress test (NST), and fetal biophysical profile every 48-72 hours. Patients were delivered as a result of spontaneous labor, clinical chorioamnionitis, fetal distress, or attainment of 37 weeks' gestation. No corticosteroids, tocolytics, or prophylactic antibiotics were used. The last biophysical profile and the last NST before delivery were evaluated for each patient. There was no statistically significant association between chorioamnionitis or fetal infection and the following: 1) a low biophysical profile (score of 6 or lower), 2) a low biophysical profile that included a nonreactive NST and absent fetal breathing movements, or 3) a nonreactive NST. We conclude that the biophysical profile and the NST are poor predictors of perinatal infectious complications.
Del Valle
G O
GO
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque.
Joffe
G M
GM
Izquierdo
L A
LA
Smith
J F
JF
Gilson
G J
GJ
Curet
L B
LB
D000293:Adolescent; D000328:Adult; D055592:Biophysical Phenomena; D001703:Biophysics; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D005322:Premature Rupture of Fetal Membranes / Q000150:complications*; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors