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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(04): e357-e361
DOI: 10.1055/s-0040-1717141
Case Report

Inpatient Biophysical Profiles and the Effect on Clinical Decision Making

Diana A. Racusin
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Suneet P. Chauhan
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Baha Sibai
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Han-Yang Chen
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Nesochi Adimorah
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Mica Piro
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Kristen Heye
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Charlotte Sharp
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
MSN WHNP-BC
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Sean Blackwell
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Jerrie Refuerzo
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
› Author Affiliations Funding None.
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Abstract

Objective Our primary objective was to determine whether biophysical profiles (BPP) performed on the antepartum unit result in changes in clinical decision making.

Study Design A retrospective cohort chart review was performed among women who had a BPP during hospital admission. BPP status was categorized as normal (8/8 points) and abnormal (6/8 or less points). The primary outcome, clinical decision making, was the need for prolonged external fetal monitoring (defined as > 2 hours) or decision to proceed with delivery. Secondary outcomes included mode of delivery, indicated preterm delivery, birth weight, 5-minute Apgar's score <7, and neonatal intensive care unit (NICU) admission.

Results Among our cohort (n = 186), 85.5% (n = 159) had a normal BPP. Delivery management was altered in one case (0.54%) by the BPP findings, and there were no BPPs that resulted in need for prolonged monitoring. Compared with women with normal BPP, women with abnormal BPPs were more likely to deliver at <37 weeks, to be admitted to the NICU, or have a 5-minute Apgar's score <7.

Conclusion In-hospital BPPs alter clinical decision making in less than 1% of cases.

Keywords

biophysical profile - antenatal fetal surveillance - decision making

Author Contributions

D.A.R. wrote the manuscript. D.A.R. and N.A. extracted and analyzed the data. K.H. and C.S. assisted with data input. H.Y.C. performed statistical analyses. S.P.C., S.B., B.S., and J.R. guided experimental design and researched data. All coauthors reviewed/edited the manuscript and contributed to the discussion.


Presented at a Meeting

Poster session (poster no.: 23 B) presented at 2018 ACOG Annual Clinical & Scientific Meeting, April 27–30, 2018, Austin, TX.




Publication History

Received: 22 January 2020

Accepted: 15 March 2020

Article published online:
12 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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