Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

Khushboo Malhotra, Archana Kumari, H. P. Anand


Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.

Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.

Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).

Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome.


High risk pregnancy, Modified biophysical profile, Non-stress test, Perinatal outcome, Umbilical artery doppler

Full Text:



Kumar MP, Gnanadeep TNV, Dixit UR, Patil PS. Prevalence of high-risk pregnancy in rural Dharwad. IOSR-JDMS. 2015;14:29-32.

Shaikh AB, Chidre YV. Comparison of the biophysical profile and modified biophysical profile in prediction of the fetal outcome in pregnancy induced hypertension. Int J Reprod Contracept Obstet Gynecol. 2017;6:1206-10.

Gonzalez JM, Stamilio DM, Ural S, Macones GA, Odibo AO. Relationship between abnormal fetal testing and adverse perinatal outcomes in intrauterine growth restriction. Am J Obstet Gynecol 2007;196:48-51.

Arias F, Daftary SN, Bhide AG. eds. Practical guide to high risk pregnancy and delivery. 3rd edition. India. Elsevier Sci Health Sci Div; 2009:17-27.

Choudhary N, Sharma BK, Kanungo BK, Yadav R, Rahman H. Assessment of doppler velocimetry versus nonstress test in antepartum surveillance of high risk pregnancy. Int J Reprod Contracept Obstet Gynecol. 2017;6:663-70.

Radhika P, Lavanya R. Fetal doppler versus NST as predictors of adverse perinatal outcome in severe preeclampsia and fetal growth restriction. J Obstet Gynecol India. 2006;56:134-8.

Shalev E, Zalel Y, Weiner E. A comparison of the non-stress test, oxytocin challenge test, Doppler velocimetry and biophysical profile in predicting umbilical vein pH in growth retarded fetuses. Int J Gynecol Obstet. 1993;43:15-9.

Sarno AP, Ahn MO, Brar HS, Phelan JP, Platt LD. Intrapartum Doppler velocimetry, amniotic fluid volume, and fetal heart rate as predictors of subsequent fetal distress. I. An initial report. Am J Obstet Gynecol. 1989;161(6 Pt 1):1508-14.

Bardakci M, Balci O, Acar A, Colakoglu MC. Comparison of modified biophysical profile and doppler ultrasound in predicting the perinatal outcome at or over 36 weeks of gestation. Gynecol Obstet Invest. 2010;69(4):245-50.

Dubiel M, Gudmundsson S, Thuring-Jönsson A, Maesel A, Marsal K. Doppler velocimetry and nonstress test for predicting outcome of pregnancies with decreased fetal movements. Am J Perinatol. 1997;14(3):139-44.