![]() ![]() However, an abnormal score may occur in a healthy fetus in the resting phase of a normal sleep–wake cycle. The lack of normal biophysical activity may be due to hypoxia, reflecting a comatose state. Because normal fetal neurodevelopment requires increasing oxygen availability, the presence of such complex biophysical activities indicates a functioning, nonhypoxemic CNS. ![]() 4 Clinical applications, efficacy, and management protocols for different clinical situations are discussed in this chapter.įetal biophysical activities such as FB, FM, and FHR-R are not random events but are controlled by specific centers within the central nervous system (CNS). The BPP may be considered a type of intrauterine Apgar score, and it may predict neonatal acidosis at delivery better than the Apgar score. It includes both acute markers of fetal status (fetal heart rate reactivity, fetal breathing movements, fetal gross body movements, and fetal tone ) and some chronic markers of the fetal and intrauterine condition (amniotic fluid volume and, in one form of the BPP, placental grading, too). This combination testing is called the biophysical profile (BPP). 3 Combination testing with an NST and real-time ultrasonographic assessment of certain fetal parameters has been used since the late 1970s. In fact, the false-positive rate of both tests is greater than 50%. 3 Unfortunately, abnormal test results are poorly predictive of an asphyxiated newborn. Reassuring NST and CST tests are highly predictive of a healthy, nonasphyxiated newborn. 2 The nonstress test (NST) and contraction stress test (CST) were the two primary methods available for fetal surveillance before the biophysical profile was developed. 1 According to the National Center for Health Statistics, this rate is defined as the number of late fetal deaths (after 28 weeks) plus infant deaths within 7 days of birth per 1000 total births after 28 weeks. In the United States, the perinatal mortality rate was 6.9 in 2001. The primary goals of antenatal surveillance programs are ultimately to decrease perinatal morbidity and mortality. These observations have aided the development of antenatal tests to distinguish healthy fetuses from potentially compromised fetuses. Much information about normal and abnormal fetal behavior has been discovered through clinical and basic science research. ![]()
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