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Antepartum Fetal Assessment

Poster Session 2

(462) Biophysical Profile in very premature fetuses

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: The applicability and interpretation of biophysical profile (BPP) in very premature fetuses have not been studied extensively. However, monitoring fetuses at < 24 wk is important because of the delivery option provided to patients at this very early gestational age. Hence, we sought to investigate if BPP score and interpretation differ according to gestational age in pregnancies between 20.0 and < 32.0 wk.


Study Design:

Prospective evaluation of BPP in uncomplicated pregnancies undergoing ultrasound for anatomic survey or fetal growth at < 32 wk was performed in 165 appropriate for gestational age fetuses that underwent 366 BPPs.  Pregnancies were grouped according to gestational age: I (20.0-23.6 wk), II (24.0-27.6 wk) and III (28.0-31.6 wk). BPP was performed until a score of 8/8 was obtained. Pregnancies with obstetric/medical indication for fetal testing and/or with fetal anomalies were excluded. Duration of the study was compared to a control group (32.0-35.6 wk) undergoing indicated BPP. If patients had > 1 BPP performed during pregnancy, each BPP was analyzed individually. ANOVA and post hoc Tukey tests were used for comparisons. 

Results:

At 30 minutes, 72% of the BPPs performed in group I and 97% in group II had a score of 8/8, whereas in group III and controls 100% of the fetuses had a BPP 8/8 within 30 minutes (P< 0.001). The mean + SD time (minutes) for a BPP 8/8 was 23 + 10 for group I, 17 + 8 for group II, 13 + 7 for group III, and 9 + 6 for controls (P< 0.001). If extending the study to 2SD (43 minutes) in group I, 97% would have achieved a score of 8/8. None of the pregnancies in groups I-III developed adverse outcomes during the study period.

Conclusion:

A score of BPP 8/8 can be obtained in a shorter time with advancing gestation, probably as consequence of fetal neurologic development and maturation. Our data indicate that a BPP can be performed reliably as early as 20.0 wk; however, in normal pregnancies, BPP of 8/8 is obtained within 43 minutes at a gestational age < 24 wk. This is important to consider when monitoring pregnancies and interpreting BPPs at these gestational ages.