Background: Numerous fetal surveillance tests have been developed to identify the fetus at risk of intrauterine injury or death but there exists limited evidence to guide their appropriate application. There are few studies that have compared Doppler velocimetry with BPP in growth restricted fetuses. Similar comparative studies are lacking for high risk pregnancies.
Aim & Objective: This study was planned to study whether BPP in high risk pregnancies offers any benefit over multi vessel Doppler velocimetry in predicting adverse perinatal outcome.
Materials and Methods: It was a prospective observational study done over 2 years in a tertiary care center in Delhi. 186 women with high risk pregnancies who met the inclusion criteria were enrolled for the study. They were divided into 2 groups – group 1, those with growth restricted fetus and group 2- those without growth restricted fetus. Fetal monitoring was done with weekly Biophysical profile and Doppler velocimetry of the fetal umbilical artery and middle cerebral artery. The S/D, PI and RI were measured for the umbilical artery and middle cerebral artery. These were then correlated with neonatal outcomes and complications.
Results: A total of 186 women were enrolled for the study. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for BPP in growth restricted fetus was 93.3%, 88.2%, 87.5%, 93.7% as compared to 81.8%, 70.5%, 78.2%, 75% for doppler. 12 were lost to follow up. The NcNemar Bowker Chi square test showed that the results of doppler and BPP for predicting adverse perinatal outcome in fetus with growth restriction was concordant. On comparing the test results of doppler with BPP in group II using McNemar Bowker Chi square test, the results were not found to be concordant (p=0.001).
Conclusion: In growth restricted fetus, doppler may replace BPP for antenatal survelliance but in other high risk fetus, they do not show a consistent relation with one another and can complement each other for antenatal survelliance.
