EFFICACY OF VIBROCOUSTIC STIMULATION AND MODIFIED BIOPHYSICAL PROFILE IN PREDICTING FETAL OUTCOME IN PERINATAL PERIOD – A PROSPECTIVE STUDY.

Dr. K Sri Tanaya; Dr. V Pradeepthi Karuna; Dr.Vijay K Yalamanchili; Dr. N. Partha Sarathy

Volume : VII, Issue : VI, June - 2017

EFFICACY OF VIBROCOUSTIC STIMULATION AND MODIFIED BIOPHYSICAL PROFILE IN PREDICTING FETAL OUTCOME IN PERINATAL PERIOD – A PROSPECTIVE STUDY.

Dr. K Sri Tanaya, Dr. V Pradeepthi Karuna, Dr. Vijay K Yalamanchili, Dr. N. Partha Sarathy

Abstract :

Background: Perinatal period is the most crucial period in obstetric management and several diagnostic modalities are available to predict the fetal outcome in this period. Objective: to evaluate the efficacy of Vioacoustic Stimulation (VAS) and Modified Biophysical Profile (MBPP) in predicting fetal outcome. Methodology: The present study was a prospective study of 100 cases of high risk pregnancy conducted over a period of 2 years from October 2011– October 2013, in The Department of Obstetrics and Gynaecology, at Alluri Sitaramaraju Academy of Medical Sciences, Eluru.The patients were evaluated with the VAS/modified biophysical profile consisting of VAS/NST followed by amniotic fluid index measurement using four quadrant technique. The test was initiated after 36 weeks of gestation who were in latent phase of labour with high risk factors included in the study. Results:A large chunk of the study group was aged between 21–30 yr (73%). Just over half of the women in my study constituted multigravida (56%) i.e second gravida and above. Of the high risk factors included in my study, the incidence of hypertensive disorders of pregnancy was the highest (22%), followed by IUGR (20%), decreased fetal movements 18%, BOH (15%), postdates (14%), diabetes, hypothyroidism and heart disease constituted minority (11%) of the cases. The incidence of abnormal NST was 15% and amniotic fluid index less than 5 was documented in 16%. VAS/MBPP was normal in 78% and abnormal in 22% of the patients.Meconium stained liquor was observed in 10% of cases. The incidence of APGAR score < 7 at 5 minutes was 15%.Total NICU admission >24 hrs i.e perinatal morbidity was 17%, the major contributor being meconium aspiration syndrome(41%), other factors leading to NICU admission were RDS (29%), hypoglycemia(11%), neonatal sepsis (11%) and hypoxic ischemic encephalopathy (5.8%).Out of 100 cases the no of babies that died were 3. Among them 2 deaths due to MAS and 1 death due to neonatal sepsis. VAS/MBPP had a high specificity (88%) and negative predictive value (93.5%) thus implying that it is a reliable diagnostic test for assessing fetal well being. As a negative or reactive test is unlikely to be associated with adverse perinatal outcome. On the other hand, a lesser sensitivity (70%) and positive predictive value (54.5%) imply that it is relatively less reliable as a screening test for identifying a compromised fetus and need further evaluation for confirming fetal compromise. In terms of perinatal deaths it showed high sensitivity (100%) and high negative predictive value (100%).So it may be useful as a rapid admission test for fetal well being. VAS/MBPP was highly significant (P value<0.05) for intrapartum fetal surveillance. Conclusion: VAS and MBPP are reliable methods for predicting fetal outcome in perinatal period.