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Re: BPP 2 and reassuring tracing From: Andrew Folley (agfolley@hotmail.com) Wed Apr 22 17:16:46 2009 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: BPP 2 and reassuring tracing" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: BPP 2 and reassuring tracing" In reply to: R. Daniel Braun: "Re: BPP 2 and reassuring tracing" Next in thread: Efrain Ramirez: "Re: BPP 2 and reassuring tracing" Reply: Efrain Ramirez: "Re: BPP 2 and reassuring tracing" My impression from the literature is the BPPs are going "out of fashion". What is currently being used is the "modified biophysical" profile. Essentially if the fetus has a reactivie tracing and a normal AFI it is equivalent to the old fashioned BPP score of 8-10 and risk of stillbirth is equally low at 1-2 per 1000. BPP or CST is only needed if NST is non reactive. Basically reactive nst implies normal fetal tone and movement (ie 4 points) and Nl AFI is good for 2 more points. Date: Wed, 22 Apr 2009 15:25:11 -0500 From: rd.braun@gmail.com To: ob-gyn-l@mail.obgyn.net Subject: Re: BPP 2 and reassuring tracing Manning & Platt's BPP included an NST done without EFM. If the ultrasonographer could see a visible increase in the heart rate with fetal movement, the NST was reactive. As with all tests, if the test is not done correctly, the results are worthless. The vast majority of abnormal BPP's, that were referred to me were really quite normal by the time I saw the patient. Upon looking into these cases, the usual cause was that the person did not observe for the full 30 minutes required to say that there was no fetal breathing or fetal movement or fetal tone. Dan On Wed, Apr 22, 2009 at 3:05 PM, art fougner, md <evsono@pipeline.com> wrote: IMHO ... Manning and Platt's biophysical profile included an NST. I personally would not accept a Biophysical profile without an NST. Art At Wed, 22 Apr 2009, Andrew Folley wrote: > >Same patient as John described. Primip at term in latent phase of labor. BPP is 2 out of 8 in the office. ie no tone, movement and no respirations but a 2 for AFI of 7. This is hypothetical situation. > >Date: Wed, 22 Apr 2009 12:10:29 -0500 >From: DoctorJoe@aol.com >To: ob-gyn-l@mail.obgyn.net >Subject: Re: BPP 2 and reassuring tracing > >In a message dated 4/22/09 11:59:18 AM, agfolley@hotmail.com writes: > >Let me turn the tables and pose this question: Same patient of Johns sent over from office >with decreased fetal movement and BPP of 2. Does she get immediatec-section? What if she is put on monitor awaiting the c-section and the tracing is "reactive" ie category I? >what do you do?? > >Doesn't a reactive strip give her a higher BPP? And is this reactive in the face of some contractions or not? > >I'd still be awfully worried about the decreased fluid and decreased (perception of) fetal movement. > >However, you've left off an important datum: gestational age. > >Joe P. > >adio Toolbar! (http://toolbar.aol.com/aolradio/download.html?ncid=emlcntusdown00000003) -- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton -- R. Daniel Braun, MD FACOG(L) ABMP CMTh Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun “Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 Next message: Efrain Ramirez: "Re: BPP 2 and reassuring tracing" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: BPP 2 and reassuring tracing" In reply to: R. Daniel Braun: "Re: BPP 2 and reassuring tracing" Next in thread: Efrain Ramirez: "Re: BPP 2 and reassuring tracing" Reply: Efrain Ramirez: "Re: BPP 2 and reassuring tracing"

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