Fetal assessment based on the fetal biophysical profile score: relationship of last BPS result to subsequent cerebral palsy.
OBJECTIVE
The prime intent of this study was to determine the relationship if any between the last fetal biophysical profile score and the risk of cerebral palsy at age 3 years. The secondary objective was to examine the clinical characteristics of infants with cerebral palsy whose obstetric management included serial fetal biophysical profile scores.


METHODS
The incidence of a high risk pregnant population whose antenatal assessment was by serial fetal biophysical profile scoring was determined by cross-referencing two discrete data bases. The completeness and reliability of the data bases was confirmed by secondary audit. Obstetrical, neonatal and post-natal clinical records of index cases of cerebral palsy were subsequently reviewed, categorized and analyzed.


RESULTS
Fetal biophysical profile scores (BPS) were recorded in 22,336 high risk pregnancies: 27 patients delivered an infant subsequently identified as having cerebral palsy (rate 1.21 per 1000). The relationship between last BPS result and cerebral palsy was inverse, exponential and highly significant (R2 = 0.987; p < 0.001). Affected infants with a last abnormal BPS result were significantly more likely to exhibit fetal distress (88.8%), acidosis (77.7%), and have neonatal seizures (88.8%). Antenatal asphyxia was the apparent cause of cerebral damage in 29.6% of cases.


CONCLUSIONS
The last fetal biophysical profile score is a predictor of the risk of cerebral palsy.
Manning
F A
FA
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Canada.
Bondagji
N
N
Harman
C R
CR
Casiro
O
O
Menticoglou
S
S
Morrison
I
I
D002547:Cerebral Palsy / Q000150:complications / Q000209:etiology*; D005260:Female; D005323:Fetal Monitoring / Q000379:methods* / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D008350:Manitoba; D008485:Medical Audit; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D015203:Reproducibility of Results; D012307:Risk Factors