Abstract
Objectives
To evaluate the efficacy of vibroacoustic stimulation (VAS) and modified fetal biophysical profile (mFBP) for early intrapartum fetal assessment and prediction of adverse perinatal outcome.
Methods
In this prospective study, 210 women who were in latent phase of labor at the time of admission to the labor unit were subjected to VAS/mFBP, in which fetal startle response and fetal heart acceleration under combined B/M mode ultrasonography following VAS were observed. The results of VAS/mFBP were correlated with adverse perinatal outcome. Standard “fourfold” format was used to calculate various diagnostic values.
Results
Mean testing time was 4.86+0.72 min. Of the 210 fetuses subjected to VAS/ mFBP, 200 (95.2%) were reactive and 10 (4.8%) nonreactive. There were 198 (94.3%) favorable and 12 (5.7%) adverse perinatal outcomes. VAS/mFBP had: sensitivity 66.7%, specificity 99.0%, positive predictive value 80.0%, negative predictive value 98.0%, and accuracy 97.2%.
Conclusions
Because of its simplicity, ease of administration, short testing time, noninvasiveness, and high accuracy VAS/mFBP for early intrapartum fetal assessment is a reliable diagnostic approach.
Keywords: vibroacoustic stimulation, modified fetal biophysical profile, intrapartum fetal assessment
Full Text
The Full Text of this article is available as a PDF (94.3 KB).
References
- 1.Blix E., Oian P. Labor admission test: an assessment of the test’s value as screening for fetal distress in labor. Acta Obstet Gynecol Scand. 2001;80(8):738–743. doi: 10.1034/j.1600-0412.2001.080008738.x. [DOI] [PubMed] [Google Scholar]
- 2.Impey L., Reynolds M., MacQuillan K., Gates S., Murphy J., Sheil O. Admission cardiotocography: a randomised controlled trial. Lancet. 2003;361(9356):465–470. doi: 10.1016/S0140-6736(03)12464-6. [DOI] [PubMed] [Google Scholar]
- 3.Tannirandorn Y., Wacharaprechanont T., Phaosavasdi S. Fetal acoustic stimulation for rapid intrapartum assessment of fetal well-being. J Med Assoc Thai. 1993;76(11):606–612. [PubMed] [Google Scholar]
- 4.Baron C., Morgan M.A., Garite T.J. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Am J Obstet Gynecol. 1995;173(1):167–174. doi: 10.1016/0002-9378(95)90185-X. [DOI] [PubMed] [Google Scholar]
- 5.Chauhan S.P., Cowan B.D., Magann E.F., Roberts W.E., Morrison J.C., Martin J.N., Jr Intrapartum amniotic fluid index a poor diagnostic test for adverse perinatal outcome. J Reprod Med. 1996;41(11):860–866. [PubMed] [Google Scholar]
- 6.Chauhan S.P., Sanderson M., Hendrix N.W., et al. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis. Am J Obstet Gynecol. 1999;181(6):1473–1478. doi: 10.1016/S0002-9378(99)70393-5. [DOI] [PubMed] [Google Scholar]
- 7.Moses J., Doherty D.A., Magann E.F., Chauhan S.P., Morrison J.C. A randomized clinical trial of the intrapartum assessment of amniotic fluid volume: amniotic fluid index versus the single deepest pocket technique. Am J Obstet Gynecol. 2004;190(6):1564–1569. doi: 10.1016/j.ajog.2004.03.046. [DOI] [PubMed] [Google Scholar]
- 8.Kim S.Y., Khandelwal M., Gaughan J.P., Agar M.H., Reece E.A. Is the intrapartum biophysical profile useful? Obstet Gynecol. 2003;102(3):471–476. doi: 10.1016/S0029-7844(03)00568-4. [DOI] [PubMed] [Google Scholar]
- 9.Inglis S.R., Druzin M.L., Wagner W.E., Koqut E. The use of vibroacoustic stimulation during the abnormal or equivocal biophysical profile. Obstet Gynecol. 1993;82:371–374. [PubMed] [Google Scholar]
- 10.Petrovic O., Frkovic A., Matejcic N. Fetal biophysical profile and vibratory acoustic stimulation in high-risk pregnancies. Int J Gynecol Obstet. 1995;50(1):11–15. doi: 10.1016/0020-7292(95)02392-P. [DOI] [PubMed] [Google Scholar]
- 11.Tongsong T., Piyamongkol W., Anantachote A., Pulphutapong K. The rapid biophysical profile for assessment of fetal well-being. J Obstet Gynaecol Res. 1999;25(6):431–436. doi: 10.1111/j.1447-0756.1999.tb01189.x. [DOI] [PubMed] [Google Scholar]
- 12.Pinette M.G., Blackstone J., Wax J.R., Cartin A. Using fetal acoustic stimulation to shorten the biophysical profile. J Clin Ultrasound. 2005;33(5):223–225. doi: 10.1002/jcu.20116. [DOI] [PubMed] [Google Scholar]
- 13.Papadopoulos V.G., Decavalas G.O., Kondakis X.G., Beratis N.G. Vibroacoustic stimulation in abnormal biophysical profile: verification of facilitation of fetal well-being. Early Hum Dev. 2007;83(3):191–197. doi: 10.1016/j.earlhumdev.2006.05.014. [DOI] [PubMed] [Google Scholar]
- 14.Tongprasert F., Jinpala S., Srisupandit K., Tongsong T. The rapid biophysical profile for early intrapartum fetal wellbeing assessment. Int J Gynaecol Obstet. 2006;95(1):14–17. doi: 10.1016/j.ijgo.2006.05.015. [DOI] [PubMed] [Google Scholar]
- 15.Manning F.A. Fetal biophysical profile: a critical appraisal. Clin Obstet Gynecol. 2002;45(4):975–985. doi: 10.1097/00003081-200212000-00004. [DOI] [PubMed] [Google Scholar]
- 16.Sarinoglu C., Dell J., Mercer B.M., Sibai B.M. Fetal startle response observed under ultrasonography: a good predictor of a reassuring biophysical profile. Obstet Gynecol. 1996;88(4Pt1):599–602. doi: 10.1016/0029-7844(96)00228-1. [DOI] [PubMed] [Google Scholar]
- 17.Skupski D.W., Rosenberg C.R., Eglinton G.S. Intrapartum fetal stimulation tests: a meta-analysis. Obstet Gynecol. 2002;99(1):129–134. doi: 10.1016/S0029-7844(01)01645-3. [DOI] [PubMed] [Google Scholar]