A Prospective Study To Assess The Role of Modified Bio Physical Profile and Cerebroplacental Ratio in Prediction of Adverse Perinatal Outcome in Pregnancies Beyond 40 Weeks of Gestation

Abstract Aim: To assess the role of modified bio physical profile and cerebroplacental ratio in prediction of adverse perinatal outcome in pregnancies beyond 40 weeks. Methodology: Pregnancies beyond 40 weeks admitted to the labor room were selected based on specific inclusion and exclusion criteria. Informed consent was obtained, and ethical approval was secured from the institute’s review board. A thorough patient assessment was conducted, including a detailed medical history, general and obstetric examinations, and routine investigations, including a Non-Stress Test (NST). Patients underwent ultrasonography to evaluate fetal well-being, gestational age, amniotic fluid index (AFI), cord status, placental localization, and Doppler studies of the umbilical artery and middle cerebral artery. This information was used to determine the Modified Biophysical Profile (BPP) and Cerebroplacental Ratio (CPR). Results: The Modified Biophysical Profile (MBPP) showed high sensitivity for NICU admissions (87.5%), APGAR scores (87.5%), and neonatal mortality (100%), with moderate sensitivity for fetal distress (78.26%) and low sensitivity for meconium-stained amniotic fluid (45.45%). Its specificity ranged from 71.59% to 93%. The Cerebroplacental Ratio (CPR) had high specificity (93.67% to 100%) but lower sensitivity (0% to 31.25%). Combined analysis indicated perfect sensitivity (100%) for NICU admissions and APGAR scores, moderate sensitivity (54.55%) and specificity (65.82%) for meconium-stained liquor, and high sensitivity (91.3%) and specificity (82.09%) for fetal distress. Conclusion: The primary aim of this study was to evaluate the effectiveness of the Modified Biophysical Profile (MBPP) and Cerebroplacental Ratio (CPR) in predicting adverse perinatal outcomes in pregnancies beyond 40 weeks. Results indicated that MBPP was significantly more sensitive than CPR for various adverse outcomes. While CPR had low sensitivity, it demonstrated high specificity, meaning abnormal CPR results indicate a higher likelihood of adverse outcomes. The combination of MBPP and CPR improved sensitivity rates, suggesting that both tests should be performed for better predictions. Further research with larger study groups is needed to enhance predictions for adverse outcomes in this population