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Radiology
Fetal Biophysical Profile
Built from Obstetric Imaging
What’s inside
8 sections · 73 slides
Overview
- What this deck covers
The Test in Outline
What the biophysical profile measures, and with what equipment
- Purpose of the biophysical profile
- Equipment used for the test
- The five variables scored
- What the ultrasound component looks at
- What the nonstress test records
- Fetal monitor display during a nonstress test
- Fetal heart rate trace
- When antepartum testing is started
- How the indications are grouped
- Indications for Antepartum Fetal Testing
- Indications for antepartum fetal testing, as printed
- Maternal conditions listed as indications
- Pregnancy-related conditions listed as indications
- Why these indications are called relative
Scoring the Test
Five variables, two points each, and what the total means
- Structure of the scoring system
- How to read the scoring table
- Biophysical Profile Scoring System
- The five criteria in plain words
- Interpretation of the total score
- Score bands and their meaning
- Value of the composite score
- Biophysical profile against fetal acidosis
- 90%
- What those accuracy figures mean
- The modified biophysical profile
- False-negative rate of antepartum surveillance
Why the Test Works
How a fetus short of oxygen changes its behaviour
- Fetal response to low oxygen
- Fetal functional responses to hypoxemia
- The two arms of the response
- Redistribution of cardiac output
- Order in which fetal activities are lost
- Thresholds behind the sequence of loss
Decreased Fetal Breathing
What it is, what mimics it, and how it is imaged
- Definition of decreased fetal breathing
- Normal pattern of fetal breathing
- Daily variation in fetal breathing
- Influences on fetal breathing
- Factors Affecting Fetal Breathing
- Factors affecting fetal breathing, as printed
- Exposures that raise and lower fetal breathing
- Effect of acidosis on fetal breathing
- Clinical presentation of absent breathing
- Ultrasound technique for fetal breathing
- M-mode recording of fetal motion
- Ultrasound transducer used for scanning
- Differential diagnosis of absent breathing
Decreased Movement and Tone
Later markers, and the sleep cycle that imitates them
- Definitions of decreased movement and tone
- When movement and tone first appear
- Hypoxemia thresholds for movement and tone
- Fetal sleep as the commonest cause
- Clinical presentation of decreased movement
- Fetal limbs and face on real-time ultrasound
- Differential diagnosis of reduced movement
The Abnormal Result
What a score of 6 or less means, and what is done about it
- What makes up a score of 6 out of 10
- Significance of oligohydramnios at a score of 6
- Scores of 0, 2 and 4 out of 10
- Perinatal mortality by biophysical profile score
- Perinatal Mortality and Biophysical Profile
- 1.86
- The mortality figures in words
- Management of an equivocal score
- Management of an abnormal score
- Action by biophysical profile result
- Care after delivery for an abnormal profile
Practice Points
The rules that stop a sleeping fetus being called a sick one
- The thirty-minute rule
- How one biophysical profile is performed
- What the referring physician needs to know
- Key points
- References
- References (continued)
- References (continued)
- Suggested readings
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition