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Re: BPP 2 and reassuring tracingFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Wed Apr 22 17:09:09 2009
At Wed, 22 Apr 2009, art fougner, md wrote: > >Readily admitting that one anecdote does not evidence make, we are all, >nevertheless, products of our experience. So my anecdote involved a >woman referred for decreased fetal movement for one day at 37 wks ... >the ultrasound revealed normal af volume, some movement, hand during the >study opened and closed and there was one episode of sustained fetal >breathing movements. The NST, however, appeared sinusoidal and >persisted that way for an hour. Vibroacoutic stimulation resulted in a >slow rise in heart rate followed by a slow return back to a persistently >sinusoidal pattern. > >Patient went to L&D and sinusoidal pattern persisted. She was delivered >by section ( I apologize for forgetting the Apgars) and the Baby was >found profoundly anemic and was transfused promptly, ultimately doing >well. > >So had I not done the NST, the outcome might have been considerably less >satisfactory. Therefore, for me, no NST = No Biophysical profile. > >Just my opinion. I could be wrong. > >Art > Art you can add one more anecdote to that, I had almost an exact similar case, my case invovled a family history of some rare hemoglobinapathy that resulted in anemia in the imediate newborn period, the mom had actual had inutero tranfusions with prior pregnancies, so she was beeing followed by twice per week NST and BPP, I was on call for a Collelque the BPP was 8/8, NST not reactive not quite a classic sinosoidal pattern put pretty close. She was a vaginal birth multip but could not bring myself to induce because of the tracing,c-section; Baby was born with a hemoglobin of 78.
--
Take care, John
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