Publication:

Modified biophysical profile in antepartum fetal surveillance of high-risk pregnancy

Background Antepartum fetal surveillance is essential for reducing perinatal morbidity and mortality in high-risk pregnancies. The modified biophysical profile (MBPP), combining the non-stress test (NST) with amniotic fluid index (AFI) assessment, offers a time-efficient, cost-effective alternative to the complete Biophysical Profile (BPP). This study evaluated MBPP as a surveillance tool in high-risk pregnancies.

Methods A hospital-based observational study was conducted at Government Medical College, Akola, Maharashtra, India (January 2024-December 2025). Three hundred high-risk pregnant women at ≥30 weeks gestation were enrolled by universal sampling. MBPP comprised a 20-minute NST and ultrasonographic AFI measurement. Outcomes included mode of delivery, neonatal Apgar scores, neonatal intensive care unit (NICU) admissions, and neonatal mortality. Data were analyzed using SPSS version 20.0 (p <0.05).

Results Most participants (51.00%) were aged 21-25 years (mean 24.75±4.56 years). Hypertensive disorders were the commonest risk factor (42.33%), followed by anaemia (28.00%) and intrauterine growth restriction (IUGR) (15.67%). NST was reactive in 78.33%; normal AFI in 81.33%; both normal in 66.67%. Full-term vaginal delivery occurred in 47.33%; emergency lower segment caesarean section (LSCS) in 34.00%. Apgar ≥7 was achieved in 83.33% neonates; 25.67% required NICU admission; neonatal mortality was 1.00%.

Conclusions MBPP is a practical, non-invasive, cost-effective antepartum surveillance tool. Abnormal MBPP findings were significantly associated with operative delivery and adverse neonatal outcomes. MBPP is recommended as a routine first-line modality for high-risk pregnancy surveillance, especially in resource-limited settings.