A Cochrane review [Abstract] 1 included 5 studies with a total of 2 974 women. A biophysical profile (BPP) includes ultrasound monitoring of fetal movements, fetal tone and fetal breathing, ultrasound assessment of liquor volume with or without assessment of the fetal heart rate. When BPP was compared with conventional fetal monitoring (cardiotocograph, CTG) or modified biophysical profile (amniotic fluid assessment and CTG), no significant differences in perinatal deaths (RR 1.33, 95% CI 0.60 to 2.98; 4 studies, n = 2839), Apgar score less than seven at five minutes (RR 1.27, 95% CI 0.85 to 1.92; 5 trials, n = 2974) and overall incidence of caesarean section (RR 1.18, 95% CI 0.90 to 1.54; 4 studies, n = 2239) were found. Data from the two high-quality trials suggest an increased risk of caesarean section in the BPP group (RR 1.60, 95% CI 1.05 to 2.44, n = 280, interaction test P = 0.03).
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by imprecise results (limited study size for each comparison).
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