Further experience with the fetal biophysical profile.

At Los Angeles County/University of Southern California Medical Center, the authors performed biophysical profile testing on 186 fetuses within one week of delivery. One component of the biophysical profile is the nonstress test. The other four components are fetal parameters observed with real-time ultrasonography: fetal breathing movements, fetal movements, fetal tone, and amniotic fluid volume. Clinicians managed the patients on the basis of the nonstress test result, and the authors did not report the other biophysical profile results. Measures of outcome included perinatal mortality, fetal distress in labor, low five-minute Apgar score, and birth weight small for gestational age. Results indicate that fetal biophysical parameters other than the response, or lack of response, of the fetal heart rate to fetal movements may have predictive value in assessing the state of fetal health. In the future, real-time ultrasonography may prove to be a reliable adjunct to antepartum electronic fetal heart rate monitoring.