Comparison of Biophysical Profile and Doppler Ultrasound in Predicting the Perinatal Outcome in High Risk Pregnancies at or over 34 Weeks Gestation

Objective: Objective of the study is to compare biophysical profile and doppler ultra sonographic analysis, to predict which is more useful in diagnosis in high risk pregnant women at or over 34 weeks gestation.

Methods: This is a prospective comparative study done at a tertiary hospital attached to Kakatiya Medical College, Warangal on 100 antenatal women with high risk factors at or over 34 weeks from October 2012 to September 2014. The risk factors included in the study were Hypertensive disorder of pregnancy, Intrauterine Growth Restriction, Post datism, Bad Obstetric History, Rh-negative pregnancy and Diabetes. Antenatal women below 34 weeks gestational age, those who are in active labor and without any risk factors were excluded from the study. In the test group women a detailed history, examination and a baseline ultrasound was done. Both Biophysical Profile and Doppler studies are conducted for every case and are followed up to the delivery and the perinatal outcome noticed.

Results: Risk factors in majority of patients are pre eclamptic toxemia group (45%) followed by IUGR (20 %) , BOH(10%), Rh Negative pregnancy (10%), post datism (10%) and diabetes complicating pregnancies(5%). Most of the women were primigravidas (62%) and were in the age group 26 -30years (46%). 40% had abnormal BPP and 34% had abnormal Doppler study. Most of them (51%) were delivered by vaginal route. The Doppler analysis was normal in 66 members and abnormal in 34 members. The perinatal outcome of the group with normal BPP and normal Doppler was better and the data was statistically significant (p < 0.001). The Doppler velocimetry had high sensitivity, specificity and negative predictive value than Biophysical profile.

Conclusion: In prediction of perinatal outcome in high risk women at or above 34 weeks gestation, the Doppler velocimetry had more sensitivity, specificity and negative predictive values than Biophysical profile. The predictive value of Doppler was increased when combined with Biophysical profile and was beneficial in perinatal prediction.