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Old 03-07-2013
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ObGyn Biophysical Profile Score Management

biophysical profile interpretations:
does oligohydroamnios with any score- delivery?

score 6 with and without oligohydroamnios management?

am not clear with scores and intervention can anyone explain in clarity. thanks
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Old 03-07-2013
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Uworld says:

1. if a score of 8-10 repeat no more than once a week til delivery

2. If presence of oligohydramnios, consider delivery

3. If score is 6 without oligohydramnios, CST should be ordered. If non reassuring results, deliver. If suspicious results, repeat the next day.

4. If a score of 4 without oligohydramnios and fetal lungs are mature, consider delivery. If immature give steroid injection. reasses in 24hours.

5. If score less than 4. deliver.

Hope this helps
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thanks Brainiac , however there is another UW question that got me confused.
it says

1. score 8 with oligo- delivery
2. score 6 without oligo-fetus less than 37-delivery
fetus more than 37weeks- repeat bpp in 24 hrs
3.score 6 with oligo-fetus less than 32 week-daily monitoring
fetus more than 32 week-delivery( before viability??)
4.score less than 4-delivery if more than 26 weeks

i fail to understand this why score 8 with oligo delivery but score 6 with oligo consider fetus gestation age? can anyone explain this and revised interpretation of BPP.
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Quote:
Originally Posted by doxorubicin View Post
thanks Brainiac , however there is another UW question that got me confused.
it says

1. score 8 with oligo- delivery
2. score 6 without oligo-fetus less than 37-delivery
fetus more than 37weeks- repeat bpp in 24 hrs
3.score 6 with oligo-fetus less than 32 week-daily monitoring
fetus more than 32 week-delivery( before viability??)
4.score less than 4-delivery if more than 26 weeks

i fail to understand this why score 8 with oligo delivery but score 6 with oligo consider fetus gestation age? can anyone explain this and revised interpretation of BPP.
The most important factor to consider in the interpretation of BPP is amniotic fluid. If you have a score of 8 and the 2 points you lost is due to oligohydramnios, you must deliver because of risk of fetal asphyxia. However if its 8 and there is no oligohydramnios, you can repeat test in a week... Good so far? Ok great! Now here comes the confusing part

Now if the score is 6 and amniotic volume is inadequte, also aim to deliver ASAP (oligo = delivery).
However, if score is 6 with normal amniotic fluid volume, the result of the test is considered equivocal and therefore should be repeated within 24 hours or go ahead and do CST.

Now I havent seen this Q in UWorld, however, what you have written above when the score is 6 seems to be opposite of the norm. Can u check to make sure its excatly what UWorld said?
What I know is that a score of 6 or 8 plus oligo is a conclusive result so deliver. A score of 6 without oligo is inconclusive so you gotta do something else - repeat test or do CST.
For scores 4 and less, brainiac's post is correct.

Also note that the GA and other factors given in the case may alter management
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BPP questions ID 3112, 3113 UW
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Quote:
Originally Posted by doxorubicin View Post
BPP questions ID 3112, 3113 UW
The explanation in 3113 is straightforward (just like I and braniac stated above). However I havent solved 3112 so I cant see the question yet from the search function. When I do, I'll post my thoughts here.
Thanks
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Originally Posted by doxorubicin View Post
i fail to understand this why score 8 with oligo delivery but score 6 with oligo consider fetus gestation age? can anyone explain this and revised interpretation of BPP.
BPP of 8 means that fetus is currently OK but due to oligo the fetus is at risk of complications like cord compression or there might be problems like chorioamnionitis or renal anomalies.

In general for oligo (risk of potential complications):

Deliver if over 37 weeks

Careful watch with 24 hourly BPP if between 34-37 weeks

Steroids if below 34 weeks
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Quote:
Originally Posted by Novobiocin View Post
BPP of 8 means that fetus is currently OK but due to oligo the fetus is at risk of complications like cord compression or there might be problems like chorioamnionitis or renal anomalies.

In general for oligo (risk of potential complications):

Deliver if over 37 weeks

Careful watch with 24 hourly BPP if between 34-37 weeks

Steroids if below 34 weeks
Nicely said. Novo, when is your test?
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