Diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia

Abstract

Objective: To determine the diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia while keeping APGAR score as gold standard Duration of Study: This study was carried out in the Department of Obstetrics and Gynaecology, Sandemen Provincial Hospital, Quetta from 1st January 2015 to 30th June 2015. A total of 105 pregnancies complicated with intrauterine growth restriction of duration from 32 to 36 weeks were included. The cases with fetuses with congenital anomalies, presenting in labour and presenting with antepartum haemorhage were excluded. Biophysical profile was done by using curvilinear real time ultrasound with a 3.5 MH transducer in growth restricted fetuses in labour room. For 8 and 10 profile score, test was considered normal. For score 6, test equivocal and score 2 and 4 are abnormal. After delivery APGAR score of fetus was assessed at 1 and 5 minutes. If at 5 min it is 10 then baby was considered well if it was less than 7, it showed birth asphyxia. Results: In our study, 63.81%(n=67) were between 18-30 years and 36.19%(n=38) were between 31-35 years of age with mean was 27.52±4.69 years, diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia while keeping apgar score as gold standard was recorded, it shows 34.29%(n=36) true positive, 7.61%(n=8) had false negative, 6.67%(n=7) false positive and 51.43%(n=54) had true negative. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate was calculated as 81.82%, 88.52%, 83.72%, 87.09% and 85.71% respectively. Conclusion: The higher diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia while keeping apgar score as gold standard. It is recommended that these high risk patients must be screened in their antenatal period for diagnosis of birth asphyxia so that proper treatment protocols may be followed.