April 4th, 2020

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Fetal Congenital Malformations: Biophysical Profile Evaluation
Authors:  Chin-Chu Lin, M.D., Charles J. Adamczyk, M.D., Zubie Sheikh, M.D., and Robert Mittendorf, M.D., Dr.P.H.
  OBJECTIVE: To study the association between various fetal congenital malformations and the biophysical profile (BPP), we tested the following hypotheses: (1) a specific organ system malformation is associated with the absence of one or more BPP parameters, and (2) four BPP parameters are not affected by the advancement of fetal maturation.

STUDY DESIGN: From 1985 to 1995, 316 fetuses with congenital malformations and 351 controls were identified in a high-risk population undergoing ultrasound examinations of anatomic structures and biophysical profile evaluations. For investigation of the influence of fetal maturity on biophysical profile evaluations, both the malformed fetuses and the controls were stratified into two gestational-age groups, 26-34 weeks and >34 completed weeks. Four parameters of the BPP, including (1) fetal breathing, (2) gross fetal movements, (3) fetal muscle tone, and (4) quantitative amniotic fluid volume, were divided into low (0-6) and high (8) total score subgroups. Tests of significance were done using c2 analysis, Student#s t test or Fisher#s exact test, as appropriate. Level of significance was set at P<.05.

RESULTS: When comparing malformed fetuses to controls, the malformed group had a statistically significantly higher percentage of low BPP scores due to absent fluid, tone or breathing. Fetuses with a musculoskeletal anomaly were statistically significantly more likely to lose points for fetal movement (P<.02); fetuses with a genitourinary system anomaly lost points for fluid (P<.001), tone (P<.005) and breathing (P<.005); fetuses with a central nervous system anomaly lost points for tone (P<.02) and breathing (P<.001); and fetuses with a thoracic anomaly lost points for breathing (P<.002). There was no statistically significant difference in BPP scores between fetuses at 26-34 weeks# gestational age and fetuses >34 completed weeks# gestational age.

CONCLUSION: The two hypotheses were confirmed by the study results. (J Reprod Med 1998;43:521-527)
Keywords:  congenital defects; fetus; biophysical profile
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