Umbilical artery waveform analysis and biophysical profile. A comparison of two methods to identify compromised fetuses.

Sixty-nine singleton high-risk pregnancies were assessed with both umbilical artery flow velocity waveform analysis and fetal biophysical profile within 10 days of delivery. An abnormal outcome, as defined as either small for gestational age at birth (SGA) or fetal distress during labour, was found in 30 babies. The peak systolic/end diastolic (A/B) ratio from the umbilical artery had a higher sensitivity (37%), specificity (92%), positive predictive value (79%) and negative predictive value (66%) than the fetal biophysical profile (27%, 82%, 53%, and 59%, respectively) in the diagnosis of abnormal outcome. Additional information from a real-time ultrasound assessment, such as the diagnosis of malformations and oligohydramnios could justify a combination of the two methods in antenatal monitoring of high-risk pregnancies.