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Re: bppFrom: DuBose, Terry (DuboseTerryJ@exchange.uams.edu)Wed Dec 10 20:00:19 1997
You are correct, as I understand it... the BPP score is reactive for fluid as long as the AFI is greater than the threshold amount. While the earliest manuscripts by Manning, Platt, et al called for a 1 cm pocket of fluid, other later publications used the AFI for 4 quadrants with a 5 cm sum. Some also multiplied the two diameters of the largest pocket (the normal range was 15-50 cm squared). If you want the references for these methods see my book FETAL SONOGRAPHY, W. B. Saunders, 1996; p. 370-373. The bottom line is that reduced fluid (assuming the kidneys and bladder are normal) is that reduced urine output is secondary to other problems associated with IUGR, like high resistance in placenta perfusion. I really don't think polyhydramnios (or just hydramnios, some think polyhydramnios is redundant) applies to the BPP. However, you should be alert to various causes of abnormal fluid levels. Poly can be due to anything that inhibits fetal drinking, these can be physical things like esophageal atresia or other anomalies (there are a lot of upper GI tract anomalies that can lead to polyhy), or neurological problems. Anybody think of any others? Hope this helps. Peace, Terry J. DuBose, M.S., RDMS; Assistant Professor Director, Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, Fellow, AIUM; Secretary, SDMS DuBoseTerryJ@Exchange.uams.edu http://www.uams.edu/chrp/dmshome.htm http://www.io.com/~dubose/ http://www.obgyn.net/CORRESP/DUBOSE.HTM http://www.obgyn.net/us/us.htm http://www.obgyn.net/women/advisors/tdubose.htm VOICE: 501-686-6510 FAX: 501-686-5613 Now is the time for all good folks to come to the aid of the Earth. -----Original Message----- From: cstewart@ruraltel.net [SMTP:cstewart@ruraltel.net] How would most of you score the AFI on a BPP if it were in the 95th to 98th %, as a 2 or as a 0. BPP only speak of Oli, or a lack of fluid. What about a Poly? Should you score it as a 2, due to the fact that it has a pocket of fluid greater than 1 cm. Or should you score poly as a 0, since the fluid amount is abnormaly high? Just wanted to get some feedback on it from the people in the know. Thanks, Clay
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