title: Diagnostic performance of a modified biophysical profile for fetal acidemia in high-risk pregnancies.
abstract: OBJECTIVE
  To determine the diagnostic performance of NST, AFI and modified-BPP for screening fetal acidemia in high-risk pregnancies.
  
  
  METHODS
  Diagnostic tests.
  
  
  METHODS
  Srinagarind (tertiary) Hospital, Faculty of Medicine, Khon Kaen University.
  
  
  METHODS
  Between April 2000 and August 2001, we included 185 high risk singleton pregnancies, GA > 37 weeks, with NST and AFI once a week until delivery. Immediately after delivery, the umbilical artery blood gases were evaluated. Fetal acidemia was defined as an umbilical artery pH < 7.15. An abnormal modified-BPP was identified when either the NST was non-reactive or the AFI was < or = 5 cm.
  
  
  RESULTS
  Thirteen high risk pregnancies were excluded because the last test was more than 7 days before delivery. Of the remaining 172 pregnancies, total fetal acidemia was identified in 19 cases. The incidence of fetal acidemia was 11.05% (95% CI 6.63-15.73). Among the 19 cases, eight had non-reactive NST and 11 had AFI < or = 5 cm but 14 with abnormal modified-BPP. The sensitivity of NST, AFI and modified-BPP was 42.11% (95% CI 34.73-49.48), 57.89% (95% CI 50.52-65.27), and 73.68%. (95% CI 67.10-80.27), respectively. The specificity, PPV, NPV, accuracy of NST, AFI and modified-BPP were high but not statistically different.
  
  
  CONCLUSIONS
  The modified-BPP had a significantly higher sensitivity than NST or AFI alone in screening for fetal acidemia, so a modified-BPP should be used to screen for fetal acidemia in high-risk pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kovit
authors.initials: K
authors.lastname: Compitak
authors.forename: Orapin
authors.initials: O
authors.lastname: Pheungtavechok
mesh_terms: D000653:Amniotic Fluid / Q000000981:diagnostic imaging*; D001703:Biophysics; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011296:Prenatal Diagnosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013785:Thailand; D016216:Ultrasonography, Prenatal