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

Authors

  • Neethika Raghuwanshi Department of Obstetrics and Gynecology, Government Medical College, Akola, Maharashtra, India
  • Sneha Gedam Department of Obstetrics and Gynecology, Government Medical College, Akola, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20262328

Keywords:

Modified biophysical profile, Antepartum fetal surveillance, High-risk pregnancy, Non-stress test, Amniotic fluid index, Perinatal outcome

Abstract

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.

Metrics

Metrics Loading ...

References

Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 26th ed. New York: McGraw-Hill Education. 2022.

Lassi ZS, Mansoor T, Salam RA, Das JK, Bhutta ZA. Essential pre-pregnancy and pregnancy interventions for improved maternal, newborn and child health. Reprod Health. 2014;11(1):S2. DOI: https://doi.org/10.1186/1742-4755-11-S1-S2

Rajbanshi S, Norhayati MN, Nik Hazlina NH. High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study. PLoS One. 2020;15(12):e0244072. DOI: https://doi.org/10.1371/journal.pone.0244072

Umana OD, Vadakekut ES, Siccardi MA. Antenatal Fetal Surveillance. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2026.

Lalor JG, Fawole B, Alfirevic Z, Devane D. Biophysical profile for fetal assessment in high risk pregnancies. Cochrane Database Syst Rev. 2008;(1):CD000038. DOI: https://doi.org/10.1002/14651858.CD000038.pub2

Marripalam SA. Comparative study of rapid biophysical profile and conventional biophysical profile in predicting perinatal outcome in high risk pregnancies. Gynecol J. 2021;5(4):297-300. DOI: https://doi.org/10.33545/gynae.2021.v5.i4e.1002

Nageotte MP, Towers CV, Asrat T, Freeman RK. Perinatal outcome with the modified biophysical profile. Am J Obstet Gynecol. 1994;170(5):1672-6. DOI: https://doi.org/10.1016/S0002-9378(12)91833-5

Anjum G, Mittal H, Chauhan N. Modified biophysical profile and perinatal outcome in high-risk pregnancies. Int J Reprod Contracept Obstet Gynecol. 2021;10(9):3357-62. DOI: https://doi.org/10.18203/2320-1770.ijrcog20213449

Shalini M, Kaskurthi V, Prathyusha V. Modified biophysical profile as antepartum fetal surveillance in predicting perinatal outcome in high risk. Int J Acad Med Pharm. 2023;5(1):196-203.

Dangal G. Role of modified biophysical profile in high risk pregnancy in predicting fetal outcome. J Nepal Health Res Counc. 2020;18(03):401-5. DOI: https://doi.org/10.33314/jnhrc.v18i3.2513

Arya TS, Thapa R. Prediction of fetal outcome in high risk pregnancy with a modified biophysical profile. Int J Gynaecol. 2017;3(1):50-3.

Mundhra R, Singh AS, Agarwal M, Kumar R. Utilization of antenatal care and its influence on fetal-maternal outcome: a tertiary care experience. Int J Reprod Contracept Obstet Gynecol. 2014;3(3):675-80.

Chourasia S, Saini V, Choudhary R. Analytical study to assess fetal and perinatal outcome in booked and unbooked obstetric cases. Int J Reprod Contracept Obstet Gynecol. 2017;6(1):147-52. DOI: https://doi.org/10.18203/2320-1770.ijrcog20164658

Nalamaru PR, Reddy VM. Modified biophysical profile in the role of predicting fetal outcome in high risk pregnancies. Indian J Obstet Gynecol Res. 2020;7(3):364-8. DOI: https://doi.org/10.18231/j.ijogr.2020.078

Sonia H, Bhavya H, Doppa G. An observational study to assess the role of modified biophysical profile and Doppler ultrasound in determining the fetal well-being in low-risk term pregnancy. J South Asian Feder Obs Gynae. 2022;14(2):144-7. DOI: https://doi.org/10.5005/jp-journals-10006-2054

Sowmya KP, Mudanur SR, Padmasri R, Lalitha S. Modified biophysical profile in antepartum fetal surveillance of high risk pregnancies. Int J Reprod Contracept Obstet Gynecol. 2017;6:1854-8. DOI: https://doi.org/10.18203/2320-1770.ijrcog20171545

Begum VA, Sruthi R, Mamatha SVS, Kameshwaramma K. Modified biophysical profile in high-risk pregnancy-association with neonatal Apgar score. Int J Reprod Contracept Obstet Gynecol. 2023;12:1000-5. DOI: https://doi.org/10.18203/2320-1770.ijrcog20230802

Borade JS, Sharma SP. The role of modified biophysical profile in predicting perinatal outcome in high risk pregnancies. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):2287-94. DOI: https://doi.org/10.18203/2320-1770.ijrcog20182337

Downloads

Published

2026-07-06

How to Cite

Raghuwanshi, N., & Gedam, S. (2026). Modified biophysical profile in antepartum fetal surveillance of high-risk pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. https://doi.org/10.18203/2320-1770.ijrcog20262328

Issue

Section

Original Research Articles