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Re: Joe- query about biophysical profileFrom: DuBose, Terry (DuboseTerryJ@uams.edu)Wed Jan 23 07:42:18 2002
Dr. Antony, this from DuBose: FETAL SONOGRAPHY, W. B. Saunders, 1996, chapter 17, "Biophysical Profile": Manning, Platt and Sipos used five variables in their design of the BioPhysical Profile (BPP) score. These five biophysical variables were fetal breathing movements (FBM), fetal movements (FM), fetal tone (FT), qualitative amniotic fluid volume (AFV) and the nonstress test (NST). Each variable was scored as a meristic or discrete variable arbitrarily having only one of two scores, 0 or 2. Therefore, if a variable is observed to be normal or "reactive" it receives a score of 2. If the variable is not observed then it receives a score of 0, and is called "nonreactive". This method gives a normal fetus a score of a perfect ten, a score of six was considered equivocal and four or below was abnormal. This initial BPP design was later modified slightly to the form similar to that in Table 17-1. The variables which are generally associated with acute asphyxia are the loss of FBM, FT, FM and heart rate variability (NST). Chronic asphyxia is indicated by oligohydramnios because the body has a natural priority, in hypoxic conditions, to shunt more blood to the fetal brain (also heart, adrenals and placenta) which reduces the blood flow to the rest of the body.,. This reduced blood flow to the body results in impaired kidney function which in turn reduces the urine contribution to the amniotic fluid. Also see: . Manning FH, Platt LD, LeMay M; "Effect of amniocentesis on fetal breathing movements"; British Med J, 1972; 2:1582-1583. . Manning FA & Platt LD; "Maternal hypoxemia and fetal breathing movements"; Obstet Gynecol, 1977; 53:758-760. . Manning FM & Platt LD; "Fetal breathing movements: Antepartum monitoring of fetal condition"; Clin Obstet Gynecol, 1979; 6:335-349. . Manning FA, Platt LD & Sipos L; "Antepartum fetal evaluation: Development of fetal biophysical profile"; Am J Obstet Gynecol, 1980; 136:787-795. . Manning FA, Baskett TF, Morrison I, et al; "Fetal biophysical profile scoring: A prospective study in 1184 high-risk patients"; Am J Obstet Gynecol, 1981; 140:289-294. . Manning FA, Morrision MB, Harman CR, et al; "Fetal assessment based on fetal biophysical profile scoring: Experience in 19221 referred high-risk pregnancies"; Am J Obstet Gynecol, 1987; 157:880-884. . Manning FA, Platt LD, Sipos L, et al; "Fetal breathing movements and the nonstress test in high-risk pregnancies"; Am J Obstet Gynecol, 1979; 135:511-515. . Manning FA, Morrison I, Lange IR, et al; "Fetal assessment based on fetal biophysical profile scoring: Experience in 12,620 referred high-risk pregnancies: 1. Perinatal mortality by frequency and etiology"; Am J Obstet Gynecol, 1985; 151:343-350. Hope this helps. Peace, Terry J. DuBose, M.S., RDMS Assistant Professor & Director, Diagnostic Medical Sonography Program CHRP, University of Arkansas for Medical Sciences Little Rock, Arkansas, USA 501-686-6510 http://www.io.com/~dubose/ <http://www.io.com/~dubose/> http://www.uams.edu/CHRP/dmshome.htm <http://www.uams.edu/CHRP/dmshome.htm> http://www.obgyn.net/us/panel/panel.htm <http://www.obgyn.net/us/panel/panel.htm> -----Original Message----- From: DR. JOE ANTONY [mailto:jscan@vsnl.com] Sent: Wednesday, January 23, 2002 4:32 AM To: Multiple recipients of list ULTRASOUND Subject: Joe- query about biophysical profile Hello all, What are the points to look for when assessing biophysical profile of the fetus? Also, when are fetal respiratory movements 1st seen? I often fail to see resp movts in an otherwise healthy 3rd trimester fetus? Is this abnormal? Dr. Joe Antony. Cochin
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