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Background: This case describes chronic anemia of a late preterm infant secondary to maternal-fetal hemorrhage and subsequent findings of maternal choriocarcinoma. Clinical Findings: This infant was born at 35 6/7 weeks gestational age via cesarean section for non-reassuring fetal heart tones. The mother presented with decreased fetal movement and the biophysical profile was 4/8. Following delivery, the infant did not require respiratory support, was vigorous with extreme pallor, and had a hemoglobin of less than 5 on cord gas. Primary Diagnosis: Chronic anemia secondary to fetomaternal hemorrhage. Interventions: The infant's initial hemoglobin was 2.4 and hematocrit was 8.1. The mother's Kleihauer-Betke test was elevated at 7%. The infant required a partial exchange transfusion following admission to the neonatal intensive care unit. Following the partial exchange transfusion, the infant began to experience increasing respiratory distress and required respiratory support. An echocardiogram showed severe persistent pulmonary hypertension of the neonate. The mother was subsequently diagnosed with choriocarcinoma. Outcomes: The infant fully recovered from chronic anemia and persistent pulmonary hypertension of the neonate and was discharged home with the mother. The infant required follow-up testing for choriocarcinoma outpatient. Practice Recommendations: Newborns diagnosed with early chronic anemia should be evaluated, the cause investigated, and appropriate treatment considered. If the cause of blood loss is unknown, a maternal Kleihauer-Betke test should be considered. In this case, a partial exchange transfusion was performed to avoid cardiovascular volume overload, but another course of treatment could include small aliquots of packed red blood cell transfusions. [ABSTRACT FROM AUTHOR]

Objective: During pregnancy, sonographic measurements of subcutaneous adipose tissue may be a reliable diagnostic predictor of gestational diabetes mellitus (GDM) and fetal metabolism. A sonographic view of the fetal abdominal circumference can be used to measure the fetal anterior abdominal wall thickness (AAWT), which is straightforward and simple. Consequently, in this study, the aim was to evaluate whether the fetal AAWT value could be used as a diagnostic indicator of GDM, thus preventing the adverse neonatal and maternal outcomes thereof, including shoulder dystocia, neonatal hypoxia, and injury to the birth canal, secondary to fetal macrosomia. Materials and Methods: This prospective cross-sectional study was conducted at a hospital in Lahore, Pakistan, over a 9-month period. A total of 176 female participants in their third trimester of pregnancy were included in this study. The participants were assigned to two cohorts: a cohort of 88 participants diagnosed with GDM and a control cohort of 88 participants without GDM. An independent sample t test, analysis of variance, and chi-square test were used to compare the characteristics between the two cohorts of participants. A final analysis was performed to determine the strength of the correlations between the estimated fetal weight (EFW) and AAWT values. Results: The GDM and control cohorts had mean fetal AAWT values of 12.65 ± 1.276 and 6.389 ± 1.503, respectively. Thus, a statistically significant difference in the fetal AAWT values was observed between the GDM and control cohorts. Furthermore, a statistically significant positive correlation between the EFW and AAWT values was observed (P =.01). Conclusion: This study highlighted that women with GDM have a considerably higher fetal AAWT values than those without GDM. In addition, the findings revealed that the AAWT value was correlated with the EFW value. Consequently, an increased fetal AAWT value can potentially be utilized as a predictive indicator for those pregnant women at risk of developing GDM, thus preventing adverse maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Objective: To determine the feasibility of extending remote maternal‐fetal care to include fetus well‐being. Methods: The authors performed a prospective pilot study investigating low‐risk pregnant participants who were recruited at the time of their first full‐term in‐person visit and scheduled for a follow‐up telemedicine visit. Using novel self‐operated fetal monitoring and ultrasound devices, fetal heart monitoring and amniotic fluid volume measurements were obtained to complete a modified biophysical profile (mBPP). Total visit length was measured for both the in‐person first visit and the subsequent telemedicine encounter. A patient satisfaction survey form was obtained. Results: Ten women between 40 + 1 and 40 + 6 weeks of gestation participated in telemedicine encounters. Nine women (90%) were able to complete remote mBPP assessment. For one participant, fetal assessment was not completed due to technically inconclusive fetal monitoring. Another participant was referred for additional assessment in the delivery room. Satisfactory amniotic fluid volume measurements were achieved in 100% of participants. The telemedicine encounter was significantly shorter (93.1 ± 33.1 min) than the in‐person visit (247.2 ± 104.7 min; P < 0.001). We observed high patient satisfaction. Conclusion: Remote fetal well‐being assessment is feasible and time‐saving and results in high patient satisfaction. This novel paradigm of comprehensive remote maternal and fetal assessment is associated with important clinical, socioeconomic, and logistics advantages. Synopsis: Remote fetal well‐being assessment is feasible and time‐saving and results in high patient satisfaction. Our approach provides significant clinical, socioeconomic, and logistics advantages. [ABSTRACT FROM AUTHOR]

Background and aims: Biophysical evaluation of fetal profile and movements is a useful tool for assessing fetal health, which even has significant effects on neonatal health. This study aimed to compare the biophysical parameters of the profile – fetal movement index, in particular – before and after corticosteroid administration in two groups receiving dexamethasone and betamethasone. Methods: In this descriptive/analytical study, 200 patients diagnosed with preterm delivery and admitted to the gynecology section of Hajar Hospital in Shahrekord in 2016 were investigated. Their demographic findings and medical histories were collected using a checklist form. Then their biophysical profiles 24 to 48 hours after corticosteroid administration were assessed. Finally, the data were analyzed by SPSS v. 18 software using t test, chi-square and Fisher exact test. Results: According to our study results, there was a significant difference in fetal movements before and after receiving corticosteroids, and the decrease in the percentage of movements was greater in the betamethasone group (P

Objective: To find the diagnostic accuracy of middle cerebral Artery Doppler findings in Intrauterine Growth Restriction taking Biophysical Profile as Gold Standard. Study Design: Cross Sectional study. Setting: Department of Radiology, Allied Hospital Faisalabad. Period: 11 February 2021 to 30 April 2022. Material & Methods: A cross-sectional study of 161 pregnant women was conducted at the radiology department of allied hospital Faisalabad. The Inclusion Criteria were 114 pregnant women with abnormal biophysical profile and with a history of previous IUGR fetus pregnancy. All women's ultrasounds were performed on color Doppler. Data was analyzed by using IBM-SPSS version 25. Results: In our study age ranged from 18-42 years with mean age of 27.2547 ± 6.46363 years. The RI of MCA ranged from 0.30-0.90 % in the IUGR patients with the mean value 0.5330 ± 0.16134, and the RI of MCA ranged from 0.60-0.70 % in the normal was 0.6632 ± 0.4828. Similarly the PI of MCA ranged from 1.00-2.00 % in the IUGR patients with the mean value 1.9825 ± 0.13187, and the PI of MCA ranged from 2.00-2.00 % in the normal was 2.0000 ± 0.00000. The biophysical profile scoring of MCA_PI with range from 0.5-0.6 was 8 in two patients while with range from 0.6-7.98 was 6 in 32 patients, and was 8 in 127 patients. Conclusion: In conclusion, the diagnostic accuracy of Color Doppler of umbilical and cerebral pulsatility is very excessive in diagnosing IUGR. [ABSTRACT FROM AUTHOR]

Growth-restricted fetuses are at risk of hypoxemia, acidemia, and stillbirth because of progressive placental dysfunction. Current fetal well-being, neonatal risks following delivery, and the anticipated rate of fetal deterioration are the major management considerations in fetal growth restriction. Surveillance has to quantify the fetal risks accurately to determine the delivery threshold and identify the testing frequency most likely to capture future deterioration and prevent stillbirth. From the second trimester onward, the biophysical profile score correlates over 90% with the current fetal pH, and a normal score predicts a pH >7.25 with a 100% positive predictive value; an abnormal score on the other hand predicts current fetal acidemia with similar certainty. Between 30% and 70% of growth-restricted fetuses with a nonreactive heart rate require biophysical profile scoring to verify fetal well-being, and an abnormal score in 8% to 27% identifies the need for delivery, which is not suspected by Doppler findings. Future fetal well-being is not predicted by the biophysical profile score, which emphasizes the importance of umbilical artery Doppler and amniotic fluid volume to determine surveillance frequency. Studies with integrated surveillance strategies that combine frequent heart rate monitoring with biophysical profile scoring and Doppler report better outcomes and stillbirth rates of between 0% and 4%, compared with those between 8% and 11% with empirically determined surveillance frequency. The variations in clinical behavior and management challenges across gestational age are better addressed when biophysical profile scoring is integrated into the surveillance of fetal growth restriction. This review aims to provide guidance on biophysical profile scoring in the in- and outpatient management of fetal growth restriction. [ABSTRACT FROM AUTHOR]

Objective: The current study aims to find out the dietary pattern among undergraduate dental students and evaluate its impact on their biophysical profile and academic achievement.Methods: A convenient sample of 150 Saudi female dental students was selected as study participants, and a close-ended questionnaire divided into two parts was distributed among them.The questionnaire included questions on their eating habits, body mass index (BMI), waist-hip ratio (WHR), and blood pressure. The collected data was statistically analyzed using SPSS version 19, and the chi-square test, correlation analysis, and descriptive statistics were performed.Results: It was observed that a majority (40%) of the study participants replaces their meals with snacks, and 26% did not take regular meals.The results reveal a significant association between blood pressure, BMI, and WHR among University female students. No significant association has been found between grade-point-average (GPA) and dietary pattern.Conclusions: The study concluded that the majority of university female students consumed unhealthy diets such as snacks. Fruit intake was lower than the recommended amount by World Health Organisation (WHO). Conducting appropriate nutrition related-public health programs would be beneficial in raising awareness regarding different aspects of dietary habits. [ABSTRACT FROM AUTHOR]

Background and aims: Biophysical evaluation of fetal profile and movements is a useful tool for assessing fetal health, which even has significant effects on neonatal health. This study aimed to compare the biophysical parameters of the profile – fetal movement index, in particular – before and after corticosteroid administration in two groups receiving dexamethasone and betamethasone. Methods: In this descriptive/analytical study, 200 patients diagnosed with preterm delivery and admitted to the gynecology section of Hajar Hospital in Shahrekord in 2016 were investigated. Their demographic findings and medical histories were collected using a checklist form. Then their biophysical profiles 24 to 48 hours after corticosteroid administration were assessed. Finally, the data were analyzed by SPSS v. 18 software using t test, chi-square and Fisher exact test. Results: According to our study results, there was a significant difference in fetal movements before and after receiving corticosteroids, and the decrease in the percentage of movements was greater in the betamethasone group (P<0.001). Also, the biophysical profile was significantly different in the dexamethasone group compared to the betamethasone group (P<0.001). No significant difference was found between two groups in terms of fetal respiration and non-stress test (NST) before and after receiving corticosteroids (P=0.47 and P=0.65, respectively). Conclusion: Dexamethasone administration had less effect on reducing fetal movement index than betamethasone administration. As the result, the biophysical profile was significantly different in the dexamethasone group compared to the betamethasone one. [ABSTRACT FROM AUTHOR]

Objective: In 2019 the American College of Obstetricians and Gynecologists (ACOG) issued specific recommendations for performance of antepartum fetal surveillance (AFS) based on individual risk factors. As similar recommendations were already in place at our institution, we have evaluated the impact of AFS on stillbirth (SB) occurrence in a 5-year cohort., Methods: Retrospective cohort study of all deliveries between 7/1/2013 and 6/30/2018. Excluded were multiples, anomalous fetuses or newborns, and deliveries before 32 0/7 weeks' gestation. AFS was conducted from 32 weeks with a modified biophysical profile, with a complete biophysical profile as back-up for non-reactive non-stress tests. All cases of SB were prospectively identified and individually reviewed to verify the presence of risk factors, the results of fetal testing if done, and calculate the interval between last fetal test and delivery. The electronic medical records during the study period were queried to identify women who underwent AFS and those who did not. Chi-square was used to compare the rates of SB between the two groups., Results: 16,827 women fulfilled the study inclusion and exclusion criteria, 5711 (34%) had risk factors which prompted AFS; 37% had 2 or more risk factors. SB occurred in 1.8‰ of them (10/5711) (3 had 1 risk factor, 5 had 2, and 2 had 3 risk factors). Rates of SB at ≥32.0 weeks were similar between women who had AFS and those who did not (1.8 vs. 2.3‰, p  = 0.51, OR = 0.75, 95%CI 0.36-1.55). The false-negative rate at <7 days of a reassuring AFS among compliant women was 1.4‰ (8/5711). Rates of preterm delivery were similar in the tested vs untested population (6.5 vs. 6.0%, p  = 0.22)., Conclusion: Implementation of AFS in women with risk factors similar to those recommended by the ACOG may lower the risk of SB from 32 weeks to that of low-risk pregnancies.

Background: College life is a crucial period and at this age, students are more likely to get involved in unhealthy lifestyle behavior like poor dietary habits, physical inactivity, and use of substances, etc. Objectives: Study objectives were to determine the lifestyle behavior of budding healthcare professions and to determine the association of bio-physical profiles with their personal profile, activity, sleep, and dietary pattern. Settings and Design: The current study adopted a cross-sectional design and carried out during May - June 2019 among 284 participants of tertiary care institute. Methods and Material: Participants were selected through a proportionate stratified sampling technique. Self-structured questionnaire and Likert scale were used to assess the lifestyle behavior of participants. Descriptive and inferential statistics were used for data analysis. Results: Majority of participants (70.7%) preferred junk food as a substitute of meal. Significant number (68.3%) of students did not exercise regularly and 30.9% have disturbed sleep pattern. One-third of them (34.5%) were in pre-hypertensive stage and alarming number of them having unacceptable body mass index (BMI) (24.7%) and waist hip ratio (28.5%). Increased BMI was significantly associated with male gender (P = 0.01) and sleep deprivation (P = 0.03). Significantly more male participants were hypertensive and pre-hypertensive (P = 0.001). Conclusions: Study data indicated that having knowledge regarding health is not enough to ensure that health professionals will follow healthy lifestyle and it is important to motivate budding health care professionals to practice healthy lifestyle with an aim of health promotion and prevention of diseases.

Objectives: Biophysical profile (BPP) is a method to check fetal health. The purpose of this study was to evaluate the effects of caffeine and acoustic stimulation on fetal BPP duration and score, and compare their results with control group with no intervention. Materials and Methods: This randomized clinical trial was conducted on 150 women who had referred to Tabriz Al-Zahra hospital. The participants were divided randomly into three groups of 50; group I (control) without intervention; group II (caffeine-recipient) who had caffeine before the procedure; and group III (acoustic stimulation) who received acoustic stimulation during the procedure using a reflex hammer. Results: Our results showed that both fetal BPP duration and fetal profile score were significantly different across the 3 groups. The fetal BPP duration was significantly shorter in the caffeine-receiving group (P=0.00), and fetal profile score in the same group was significantly higher (P=0.00). Conclusions: Generally, using caffeine-containing drink before BPP tests may result in shorter test duration and higher test score.

Background: Intrauterine growth restriction is one of the most common causes of perinatal morbidity and mortality worldwide. Strong evidence about the optimum method of surveillance is needed. Objective: to determine the relationship between biophysical fetal parameters and arterial and venous Doppler parameters in fetuses with severe intrauterine growth restriction (IUGR). Patients and Methods: This is a Prospective cohort study was conducted at Menoufia University Hospital during the period from March 2019 to September 2020. Fourty two IUGR fetuses with elevated Umbilical Artery (UA) Doppler had follow up with Doppler (UA, middle cerebral artery and ductus venosus) and Biophysical profile (BPP). Patients were stratified into three groups: G1: abnormal UA alone. G2: brain sparing effect. G3: abnormal DV Doppler. Our main primary outcome was neonatal intensive care unit (NICU) admission while secondary outcomes were APGAR score, Birth weight, EFW and stillbirth rate. Results UAEDV was present in 29 fetuses (69%), Absent/Reversed (AREDV) in 13 (31%). Brain sparing was observed in 18 fetuses (42.85%). Abnormal DV Doppler was noticed in 5 fetuses (11.9%). The BPP was > 6 in 28 fetuses (66.6%). Abnormal doppler (UA, MCA, DV) and abnormal BPP were significantly associated with increased NICU admissions, Still birth rates, lower APGAR scores, EFW and Birth weight. Multivariate regression analysis was performed, and it was found that abnormal MCA was the most associated parameter with NICU admission. Conclusion: Fetal Doppler (UA, MCA, DV) and BPP are complementary antenatal modalities. Therefore, pursuit of a combined testing approach has merit. [ABSTRACT FROM AUTHOR]

Objective Our primary objective was to determine whether biophysical profiles (BPP) performed on the antepartum unit result in changes in clinical decision making. Study Design A retrospective cohort chart review was performed among women who had a BPP during hospital admission. BPP status was categorized as normal (8/8 points) and abnormal (6/8 or less points). The primary outcome, clinical decision making, was the need for prolonged external fetal monitoring (defined as > 2 hours) or decision to proceed with delivery. Secondary outcomes included mode of delivery, indicated preterm delivery, birth weight, 5-minute Apgar's score

Objective: Having a rapid and low cost diagnostic approach in assessment of fetal wellbeing is an important goal for prenatal care process. The aim of this study was to determine the diagnostic value of rapid biophysical profile (rBPP) in comparison to biophysical profile (BPP). Materials and methods: In this study 142 pregnant women with insulin-dependent diabetes referred to Besat Hospital (Sanandaj, Iran) were evaluated in terms of fetal health. Age, gestational age and non-stress test (NST) data of patients were collected. The fetuses were evaluated using the standard BPP and selected rBPP methods. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated. The receiver operating characteristic (ROC) curve was plotted. The data were analyzed in Stata 14 software, using appropriate statistical analyses. Results: The mean ± standard deviation (SD) of maternal age and gestational age of the studied subjects were 30.6 ± 6.3 and 35.6 ± 1.5 weeks, respectively. The frequency of normal cases were 126 (88.7%) in the BPP method and 121 (85.2%) in the rBPP method. The results showed that sensitivity, specificity, PPV and NPV of rBPP in this study were 56.2%, 90.5%, 42.8% and 94.2%, respectively. The area under the ROC curve was 73.3%. Pearson Test showed a significant correlation between scores obtained through BPP and rBPP methods (p < 0.001). Conclusion: Considering the high profile of the sensitivity and PPV of the RBPP method compared to BPP, rBPP method has a better capacity to discriminate non-distressed fetuses from distress-exposed fetuses. It can also be used as a quick and easy method in crowded centers with limited evaluation tests, where not much skill is needed.

Background: College life is a crucial period and at this age, students are more likely to get involved in unhealthy lifestyle behavior like poor dietary habits, physical inactivity, and use of substances, etc. Objectives: Study objectives were to determine the lifestyle behavior of budding healthcare professions and to determine the association of bio-physical profiles with their personal profile, activity, sleep, and dietary pattern. Settings and Design: The current study adopted a cross-sectional design and carried out during May - June 2019 among 284 participants of tertiary care institute. Methods and Material: Participants were selected through a proportionate stratified sampling technique. Self-structured questionnaire and Likert scale were used to assess the lifestyle behavior of participants. Descriptive and inferential statistics were used for data analysis. Results: Majority of participants (70.7%) preferred junk food as a substitute of meal. Significant number (68.3%) of students did not exercise regularly and 30.9% have disturbed sleep pattern. One-third of them (34.5%) were in pre-hypertensive stage and alarming number of them having unacceptable body mass index (BMI) (24.7%) and waist hip ratio (28.5%). Increased BMI was significantly associated with male gender (P = 0.01) and sleep deprivation (P = 0.03). Significantly more male participants were hypertensive and pre-hypertensive (P = 0.001). Conclusions: Study data indicated that having knowledge regarding health is not enough to ensure that health professionals will follow healthy lifestyle and it is important to motivate budding health care professionals to practice healthy lifestyle with an aim of health promotion and prevention of diseases. [ABSTRACT FROM AUTHOR]

Objective: Having a rapid and low cost diagnostic approach in assessment of fetal wellbeing is an important goal for prenatal care process. The aim of this study was to determine the diagnostic value of rapid biophysical profile (rBPP) in comparison to biophysical profile (BPP). Materials and methods: In this study 142 pregnant women with insulin-dependent diabetes referred to Besat Hospital (Sanandaj, Iran) were evaluated in terms of fetal health. Age, gestational age and nonstress test (NST) data of patients were collected. The fetuses were evaluated using the standard BPP and selected rBPP methods. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated. The receiver operating characteristic (ROC) curve was plotted. The data were analyzed in Stata 14 software, using appropriate statistical analyses. Results: The mean ± standard deviation (SD) of maternal age and gestational age of the studied subjects were 30.6 ± 6.3 and 35.6 ± 1.5 weeks, respectively. The frequency of normal cases were 126 (88.7%) in the BPP method and 121 (85.2%) in the rBPP method. The results showed that sensitivity, specificity, PPV and NPV of rBPP in this study were 56.2%, 90.5%, 42.8% and 94.2%, respectively. The area under the ROC curve was 73.3%. Pearson Test showed a significant correlation between scores obtained through BPP and rBPP methods (p < 0.001). Conclusion: Considering the high profile of the sensitivity and PPV of the RBPP method compared to BPP, rBPP method has a better capacity to discriminate non-distressed fetuses from distress-exposed fetuses. It can also be used as a quick and easy method in crowded centers with limited evaluation tests, where not much skill is needed. [ABSTRACT FROM AUTHOR]

Autism, also known as an autism spectrum disorder, is a complex neurodevelopmental disorder usually diagnosed in the first three years of a child's life. A range of symptoms characterizes it and can be diagnosed at any age, including adolescence and adulthood. However, early diagnosis is crucial for effective management, prognosis, and care. Unfortunately, there are no established fetal, prenatal, or newborn screening programs for autism, making early detection difficult. This review aims to shed light on the early detection of autism prenatally, natally, and early in life, during a stage we call as "pre-autism" when typical symptoms are not yet apparent. Some fetal, neonatal, and infant biomarkers may predict an increased risk of autism in the coming baby. By developing a biomarker array, we can create an objective diagnostic tool to diagnose and rank the severity of autism for each patient. These biomarkers could be genetic, immunological, hormonal, metabolic, amino acids, acute phase reactants, neonatal brainstem function biophysical activity, behavioral profile, body measurements, or radiological markers. However, every biomarker has its accuracy and limitations. Several factors can make early detection of autism a real challenge. To improve early detection, we need to overcome various challenges, such as raising community awareness of early signs of autism, improving access to diagnostic tools, reducing the stigma attached to the diagnosis of autism, and addressing various culturally sensitive concepts related to the disorder., Competing Interests: Conflict-of-interest statement: Authors declare no conflict of interests for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objectives: Biophysical profile (BPP) is a method to check fetal health. The purpose of this study was to evaluate the effects of caffeine and acoustic stimulation on fetal BPP duration and score, and compare their results with control group with no intervention. Materials and Methods: This randomized clinical trial was conducted on 150 women who had referred to Tabriz Al-Zahra hospital. The participants were divided randomly into three groups of 50; group I (control) without intervention; group II (caffeine-recipient) who had caffeine before the procedure; and group III (acoustic stimulation) who received acoustic stimulation during the procedure using a reflex hammer. Results: Our results showed that both fetal BPP duration and fetal profile score were significantly different across the 3 groups. The fetal BPP duration was significantly shorter in the caffeine-receiving group (P=0.00), and fetal profile score in the same group was significantly higher (P=0.00). Conclusions: Generally, using caffeine-containing drink before BPP tests may result in shorter test duration and higher test score. [ABSTRACT FROM AUTHOR]

Fetal growth restriction, or an estimated fetal weight of less than the 10th percentile, is associated with adverse perinatal outcome. Optimizing management for obtaining the most favorable outcome for mother and fetus is largely based on detailed ultrasound findings. Identifying and performing those ultrasound procedures that are most associated with adverse outcome is necessary for proper patient management. Transabdominal ultrasound is the mainstay of initial management and assessment of fetal growth. For those fetuses that are identified as small for gestational age, assessment of fetal well-being with biophysical profile and Doppler velocimetry provide vital information for differentiating those fetuses that may be compromised and may require delivery and those that are well compensated. Delivery of the pregnancy is primarily based upon the gestational age of the pregnancy and the ultrasound findings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Abstract Prepartum fetal surveillance techniques have been widely used in both human and veterinary obstetrics, although these tests differ in their sensitivity for the assessment of fetal well-being. In equine reproduction, the 'gold standard' examination technique is the equine biophysical profile (EBP) described by Virginia Reef in 1995. Although this fetal assessment has many benefits, its accuracy, sensitivity and specificity have not been evaluated so far. In this study, 129 late-term pregnant mares were scanned twice in their last month of gestation using two different protocols (the EBP and a new, rapid examination protocol, REP) in order to determine the accuracy of these tests. The REP included the determination of fetal heart rate, fetal aortic diameter and the combined thickness of the uteroplacental unit. Twenty-seven fetuses proved to be compromised and 102 mares had healthy asymptomatic foals. Statistical analyses showed slight differences in test sensitivity (81.48% and 85.19%), specificity (83.3% and 87.25%) and accuracy (82.95% and 86.82%) for EBP and REP, respectively. Furthermore, a statistically significant interchangeability could be demonstrated between the two methods. It is concluded that, depending on the prevalence of the disease (here: compromised state), both methods are useful for the diagnosis of fetal abnormalities and make it possible to provide satisfactory care for broodmares and their fetuses. Highlights • Prepartum fetal ultrasonography is the most valuable form of monitoring health status in equine fetuses. • Sensitivity, specificity and accuracy of the equine biophysical profile (EBP) have not been tested so far. • Two examination protocols (EBP and REP) have been compared statistically during 4 consecutive years. • Statistical analyses showed slight differences in test sensitivity, specificity and accuracy. [ABSTRACT FROM AUTHOR]

Introduction: The objective is to assess if fetal halogen light stimulation can reduce the time needed to obtain a normal biophysical profile (BPP).Methods: Patients scheduled for a BPP and who satisfied the inclusion criteria were prospectively randomized to halogen light stimulation and no stimulation groups. The study group was exposed to handheld halogen light for 10 s whenever fetal breathing, movement, or tone was absent through the first 5 min of BPP. The time required to achieve complete BPP score was recorded. In patients with complete BPP score who had delivery within 1 week after the test, perinatal morbidity was examined.Results: A total of 598 patients were randomized (light = 302, no light = 296). There was no difference between the two groups in terms of gestational age, maternal age, body mass index, and indication for BPP except for preterm labor (light: 9%, no light: 4%, p = 0.03). Among the patients who had a normal BPP score (n = 507), the mean (light: 7.1 ± 6 min, no light: 12.3 ± 8 min, p < 0.0001) and median (light: 4.3, no light: 8, p = 0.004) time needed to complete the BPP score was significantly less in the light stimulation group than the no stimulation group. Perinatal outcomes were not different between groups who had delivery during the first week after BPP.Conclusion: Fetal halogen light stimulation can be utilized to reduce the time needed to complete a BPP. However, further studies should be conducted in order to determine the effect of this method on decreasing non-reassuring test results.Clinical Trial Registration: The study was submitted to the Registry of Clinical Trials on 04/20/2017 (IRCT2017041633470N1). After IRCT registration on 06/07/2017, we recruited patients from 06/08/2017 till 10/15/2017. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the biophysical profile parameters (BPP), especially amniotic fluid index (AFI), before and after administration of corticosteroids (dexamethasone and betamethasone) and these two groups with each other. Materials and Methods: This double-blind clinical trial study was done on 70 patients for 28-34 weeks women having at least one preterm labor in their previous pregnancy has been submitted in Al Zahra and Shahid Beheshti clinic in 2012-2013. 70 women were randomly allocated in two groups. The first group were received 8 mg each 12 h for 4 doses dexamethasone when the patient at risk of preterm labor admitted in clinic or hospitalized and the second group were received 12 mg betamethasone each 24 h similarly. Nonstress test (NST) and BPP and sonography AFI were done in all cases, and then NST was done in the before and 3 days after intervention. Data were analyzed by SPSS software version 20 using t-test, Chi-square, and Fisher′s test. Results: There was no significant difference between the range of AFI before and after the drug intervention (P > 0.05). Two groups had no significant difference in AFI before and after administration of corticosteroids. No significant difference was seen in NST acceleration tests between the two groups before and after corticosteroids administration. Conclusion: Biophysical profile had a significant difference in dexamethasone group respect to that of betamethasone group. Furthermore, the biophysical profile had a significant difference before and after the administration of corticosteroids in two groups. It is noted that AFI had no role in this matter.

Aim: To evaluate whether antenatal betamethasone affects the fetal biophysical profile (BPP) and Doppler indices of umbilical and middle cerebral arteries (MCAs) in cases of preeclampsia without severe features.Materials and Methods: Forty singleton preeclamptic pregnancies without severe features at gestational ages of 28-34 weeks were randomly divided into two groups of 20 patients: betamethasone and control groups. Patients in the betamethasone group were administered two consecutive doses of 12 mg betamethasone intramuscularly, 24 h apart, and patients in the control group were administered the same volume of saline as a placebo. All participants were evaluated before (0 h) and at hours 24, 48, and 72 of betamethasone/placebo administration using BPP scoring and umbilical and MCA Doppler examinations.Results: Total BPP scores were significantly lower in the betamethasone group across the three time points during the follow-up period (p < 0.001). None of the Doppler indices differed significantly between the groups (p > 0.05).Conclusion: Antenatal betamethasone negatively affects fetal BPP score parameters, including the non-stress test, fetal body and breathing movements, without affecting vascular indices of umbilical arteries and MCAs. Clinician awareness of this transient drug-induced effect might be valuable for preventing iatrogenic preterm delivery for fetuses in preeclamptic pregnancies without severe features. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to determine whether ambient light serves as a fetal stimulus to decrease the amount of time needed to complete a biophysical profile.Study Design: This is a randomized controlled trial of singleton gestations undergoing a biophysical profile. Patients were randomized to either ambient light or a darkened room. The primary outcome was the time needed to complete the biophysical profile. Secondary outcomes included total and individual component biophysical profile scores and scores less than 8. A subgroup analysis of different maternal body mass indices was also performed.Results: 357 biophysical profile studies were analyzed. 182 studies were performed with ambient light and 175 were performed in a darkened room. There was no difference in the median time needed to complete the biophysical profile based on exposure to ambient light (6.1min in darkened room versus 6.6min with ambient light; P=0.73). No difference was found in total or individual component biophysical profile scores. Subgroup analysis by maternal body mass index did not demonstrate shorter study times with ambient light exposure in women who were normal weight, overweight or obese.Conclusion: Ambient light exposure did not decrease the time needed to complete the biophysical profile. There was no evidence that ambient light altered fetal behavior observed during the biophysical profile. [ABSTRACT FROM AUTHOR]

Objectives: To determine the diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia. Study Design: Crosssectional study. Settings: Department of Radiology / Obstetrics & Gynaecology Faisalabad Medical University, Faisalabad and affiliated Hospitals. Duration of Study: The study was carried out for a period of one calendar year, 1st January, 2016 to 31st December, 2016. Material & Methods: Total 105 patients admitted through OPD and emergency fulfilling the criteria were included in this study. Results: In our study, 63.81% (n=67) were between 18-30 years and 36.19% (n=38) were between 31-35 years of age, mean+sd was calculated as 27.52+4.69 years diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia while keeping Apgar score as gold standard was recorded, it shows 34.29% (n=36) true positive, 7.61%(n=8) had false negative, 6.67%(n=7) false positive and 51.43%(n=54) had true negative. Sensitivity, specificity, and diagnostic accuracy rate were calculated as 81.82% 88.52% and 85.71% respectively. Conclusion: Higher diagnostic accuracy of biophysical profile in preterm fetuses with intrauterine growth restriction for diagnosis of birth asphyxia. It is recommended that these high risk patients must be screened in their antenatal period for diagnosis of birth asphyxia so that proper treatment protocols may be followed. [ABSTRACT FROM AUTHOR]

Introduction. Intrauterine growth restriction (IUGR) affects 5-10% of pregnancies and represents the second cause of perinatal mortality. Early-onset IUGR is usu- ally caused by placental dysfunction, but many other causes may be involved. Case report. We present the case of a 42-year-old woman, IIP, referred for amniocen- tesis for high genetic risk (trisomy 18) revealed by the noninvasive prenatal test (NIPT) for fetal aneuploidies. The amniocentesis performed at 16 weeks and 6 days showed a normal karyotype. A detailed second-trimester anomaly scan was repeated at 22 weeks and confirmed no signs of fetal structural abnormalities, an estimated fetal weight (EFW) at percentile (p) 16, and a pulsatility index (PI) within normal ranges for both uterine arteries and umbilical artery (UA). No signs of an active infec- tion were found at the specific investigations, including extended TORCH complex, and thrombophilia was ruled out. During the following weeks, the fetus developed symmetric IUGR<8th percentile, with normal UA, MCA (middle cerebral artery), and ductus venous (DV) flows. At 30 weeks, the EFW was at percentile 5.2. At 32 weeks, we noticed a deterioration of the fetal well-being with a non- reactive nonstress test, absent end-diastolic flow in UA, but with normal DV Doppler. The patient was admitted for closer surveillance, corticotherapy and magnesium sulfate therapy. The CPR (cerebral-placental ratio) was <5th percentile, and PI-UA was above percentile 95. Two days later, the CPR reversed, the short-term variations on cardiotocography decreased at 3.1 ms, and an 1130 g fetus was delivered by caesarean section, with an Apgar score of 7. Overall, the outcome was favorable, with the newborn discharged after one month. Conclusions. In early-onset IUGR, optimal monitoring and delivery timing are crucial. Doppler scanning (uterine arteries, UA and MCA) and biophysical monitoring help prevent acidemia and stillbirth. Placental mosaicism must be considered in cases where NIPT results are not con- firmed by invasive genetics. [ABSTRACT FROM AUTHOR]

Introduction Preterm birth is a major cause of perinatal death and disability and emerges as an important global public health problem. The antenatal administration of corticosteroids for preventing neonatal death due to respiratory distress syndrome and the serious morbidities associated with preterm birth has become an accepted standard in worldwide obstetric practice since 1994. After administering corticosteroids, the biophysical score deteriorates transiently, leading to a high cesarean section rate. Thus, Doppler indices of the umbilical and middle cerebral arteries are taken into account before the termination of pregnancy in preterm labor. Materials and methods This is an interventional study conducted over a period of one year and six months among 59 eligible singleton pregnancies at risk for preterm delivery, i.e., at risk of preterm birth <34 weeks of gestation, having no contraindication to antenatal steroids, who were admitted to the labor room of the Srirama Chandra Bhanja (SCB) Medical College, Cuttack, India, from January 2014 to August 2015. The participants were prospectively recruited, after giving informed consent to participate in the study. The main indication for hospital admission and steroid use was preterm lower abdominal pain. Results Out of 59 eligible cases, 27 (45.8%) were <25 years of age, 26 (44.1%) were between 25 and 30 years of age, and six (10.2%) were >30 years of age. The range is 14 years (between 19 and 33 years). The mean age is 25.31 years, with a standard deviation of 3.74. The mean of the biophysical profile (BPP) score before steroid administration decreased from 9.19 ± 1.23 to 5.56 ± 1.05 after 48 hours of first dose of steroid. The p-value of this is <0.001, which is statistically significant. The results show that the administration of betamethasone decreased fetal movements by 78.6% and breathing by 71.8%. As a result, the BPP scores decreased significantly. However, the Doppler indices did not change significantly even after administering corticosteroids. Conclusion Doppler indices play an important role in differentiating between steroid-induced compromise in the fetus and real fetal distress. Thus, umbilical and middle cerebral artery (MCA) Doppler should always be done before the termination of pregnancy on the ground of fetal compromise after administering corticosteroids., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Behera et al.)

Introduction: Fetal movement counting is a method used by mother to quantify her baby's movements. However, the optimal number of movements and the ideal duration of counting them have not been recognized. The aim of this study was to determine the diagnostic value of the two common fetal movements counting methods by mother including "ten fetal movements counting in two hours" and "three fetal movements counting in one hour" and to compare the required mean time for counting fetal movements in the two methods. Methods: 300 subjects were selected by random sampling among clients with complains of decreased fetal movements referring to AL-Zahra educational curative center in Tabriz, Iran. Full training about how to perform the two methods of fetal movements counting and how to record in related tables was instructed by researcher. Immediately after counting movements, biophysical profile test was performed. Results: Among a total of 291 mothers in the two groups, 99.7% had active fetuses based on both methods of fetal movement counting. 96.9% of these active fetuses obtained score of 10 in biophysical profile. There was a statistically significant relation between the results of both two methods of fetal movement counting and the biophysical profile as the gold standard. Sensitivity, specificity, positive and negative predictive values of both methods were equally 100%, 96%, 10% and 100%, respectively. Conclusion: The findings of this study showed that fetal movement counting test can be used as an initial screening method in predicting fetal health.

Introducción: el diagnóstico de corioamnionitis se basa en criterios clínicos que no alcanzan una sensibilidad mayor al 60%, y que tienen poca utilidad para predecir el compromiso fetal. El ultrasonido surge como una alternativa útil en el diagnóstico. Al mejorar el diagnóstico con la búsqueda de marcadores ecográficos de infección fetal podemos impactar en la morbimortalidad perinatal al poder intervenir de forma temprana a las gestantes en riesgo de compromiso fetal, especialmente corioamnionitis con curso subclínico. El objetivo de esta revisión es conocer la evidencia que soporta la asociación entre los hallazgos ecográficos del ultrasonido y la presencia de corioamnionitis e infección fetal in utero. Materiales y métodos: se realizó una revisión de la literatura existente en las bases de datos medline, ovid, ebsco, ProQuest, lilacs, SciELO desde enero de 1985 hasta octubre de 2012. Se incluyeron los artículos de revisión e investigaciones originales. Resultados: en las gestantes con parto pretérmino y ruptura prematura de membranas ovulares el acortamiento cervical, la presencia de “sludge”, el oligohidramnios y la involución del timo son los marcadores que han mostrado mayor asociación con infección amniótica. Conclusiones: el ultrasonido es una herramienta por considerar en el diagnóstico de infección materna y fetal in utero.Introduction: A diagnosis of chorioamnionitis is based on clinical criteria which only manage 60% sensitivity and have little usefulness in predicting fetal compromise. Ultrasound emerges as a useful diagnostic alternative. An impact might be made on perinatal morbimortality by improving diagnosis through the search for echographic markers of fetal infection, thereby enabling early intervention in pregnant women at risk of fetal compromise, especially regarding subclinical chorioamnionitis. This review was aimed at providing evidence supporting an association between ultrasound’s echographic findings and the presence of chorioamnionitis in in utero (congenital) fetal infection. Materials and methods: A review of the existing literature was made in medline, ovid, ebsco, ProQuest, lilacs and scielo databases from January 1985 to October 2012. Original research and review articles were included. Results: Cervical length shortening, the presence of sludge, oligohydramnios and thymus involution are the markers which have been shown to have the greatest association with intra-amniotic infection. Conclusions: Ultrasound is a tool to be considered when diagnosing in utero maternal and fetal infection.

Background & Aim: The Non Stress Test (NST) is a main assessment tool for fetal wellbeing; however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST.Methods & Materials: From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean± SD, chi-square Test and Fisher's Exact Test. The >α0.05 was considered as significant level.Results: Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes.Conclusion: Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment.

Background & Aim: The Non Stress Test (NST) is a main assessment tool for fetal wellbeing however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST. Methods & Materials: From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean± SD, chi-square Test and Fisher&aposs Exact Test. The >α0.05 was considered as significant level. Results: Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes. Conclusion: Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment.

"nBackground: The Biophysical Profile (BPP) is a noninvasive test that predicts the presence or absence of fetal asphyxia and, ultimately, the risk of fetal death in the antenatal period. Intervention on the basis of an abnormal biophysical profile result has been reported to yield a significant reduction in prenatal mortality, and an association exists between biophysical profile scoring and a decreased cerebral palsy rate in a given population. The BPP evaluates five characteristics: fetal movement, tone, breathing, heart reactivity, and amniotic fluid (AF) volume estimation. The purpose of study was to determine whether there are different degree of acidosis at which the biophysical activity (acute marker) are affected. "nMethods: In a prospective study of 140 patients undergoing cesarean section before onset of labor, the fetal biophysical profile was performed 24h before the time of cesarean and was matched with cord arterial PH that was obtained from a cord segment (10-20cm) that was double clamped after delivery of newborn. (using cord arterial PH less than 7.20 for the diagnosis of acidosis). "nResults: The fetal biophysical profile was found to have a significant relationship with umbilical blood PH. The sensitivity, specificity, positive predictive value, negative predictive value of fetal biophysical profile score were: 88.9%, 88.6%, 50%, 98.1%. "nConclusion: The first manifestations of fetal acidosis are nonreactive nonstress testing and fetal breathing loss; in advanced acidemia fetal movements and fetal tone are compromised. A protocol of antepartum fetal evaluation is suggested based upon the individual biophysical components rather than the score alone.