US Pregnant Uterus Biophysical Profile The BPP is the mainstay of fetal well-being evaluation and consists of four parameters variably sensitive to the acute exposure of the fetus to hypoxemia: fetal breathing movements, fetal limb and body movements, fetal tone, and amniotic fluid volume (which is thought to be more of an indicator of chronic hypoxemia). The NST, which is sometimes included with the BPP as a fifth component, can be used alone as a test of acute fetal well-being status, but it is often coupled with amniotic fluid measurement, a valuable reflection of fetal hypoxemic exposure over the previous week. Each of the four (or five) components of the BPP receives a score of 0 or 2, leading to a maximum score of 8 (or 10). Scores of 8 (or 10) are strong indicators of a well-compensated fetus [27]. For those at risk for fetal demise, testing strategies usually evaluate one or more of the fetal well-being parameters at least weekly. For the well-being of those fetuses at highest risk for fetal demise, testing can often occur twice weekly or even daily, from the point of postnatal viability until delivery is indicated. Amniotic fluid volume is usually assessed at least weekly, but may be evaluated more often if it is approaching severely low levels. Daily or even more frequent testing by BPP or NST may be indicated in critical situations. To our knowledge, there are no trials evaluating the use of the BPP as an initial procedure among those at low risk for FGR. US Duplex Doppler Velocimetry Fetal Umbilical Artery Although much research has centered on the use of Doppler velocimetry of the fetal umbilical artery among fetuses with known FGR, little work has been done among fetuses in women who are felt to be at low risk for FGR. In fact, umbilical artery Doppler velocimetry has not been shown to be a useful screening tool for FGR [31].
Growth Disturbances Risk of Fetal Growth Restriction. US Pregnant Uterus Biophysical Profile The BPP is the mainstay of fetal well-being evaluation and consists of four parameters variably sensitive to the acute exposure of the fetus to hypoxemia: fetal breathing movements, fetal limb and body movements, fetal tone, and amniotic fluid volume (which is thought to be more of an indicator of chronic hypoxemia). The NST, which is sometimes included with the BPP as a fifth component, can be used alone as a test of acute fetal well-being status, but it is often coupled with amniotic fluid measurement, a valuable reflection of fetal hypoxemic exposure over the previous week. Each of the four (or five) components of the BPP receives a score of 0 or 2, leading to a maximum score of 8 (or 10). Scores of 8 (or 10) are strong indicators of a well-compensated fetus [27]. For those at risk for fetal demise, testing strategies usually evaluate one or more of the fetal well-being parameters at least weekly. For the well-being of those fetuses at highest risk for fetal demise, testing can often occur twice weekly or even daily, from the point of postnatal viability until delivery is indicated. Amniotic fluid volume is usually assessed at least weekly, but may be evaluated more often if it is approaching severely low levels. Daily or even more frequent testing by BPP or NST may be indicated in critical situations. To our knowledge, there are no trials evaluating the use of the BPP as an initial procedure among those at low risk for FGR. US Duplex Doppler Velocimetry Fetal Umbilical Artery Although much research has centered on the use of Doppler velocimetry of the fetal umbilical artery among fetuses with known FGR, little work has been done among fetuses in women who are felt to be at low risk for FGR. In fact, umbilical artery Doppler velocimetry has not been shown to be a useful screening tool for FGR [31].