Sonographic assessment of rapid biophysical profile among hypertensive pregnant women in late 2nd and 3rd trimesters in a tertiary hospital

Sonographic assessment of pregnant women

Abstract

Abstract

Background: Hypertensive disorders in pregnancy are a major cause of maternal and fetal complications globally. Timely and reliable fetal surveillance is critical for reducing adverse outcomes, especially in resource-limited settings. The rapid biophysical profile (rBPP) offers a simplified method for assessing fetal well-being using amniotic fluid index (AFI) and sound-provoked fetal movement (SPFM).

Objective: To determine the rBPP scores of fetuses in hypertensive pregnant women and evaluate the relationship between maternal hypertension and fetal rBPP outcomes during the late second and third trimesters.

Methods: A cross-sectional study was conducted at Usmanu Danfodiyo University Teaching Hospital, Sokoto, from July to October 2024. Seventy-four hypertensive pregnant women in their late second or third trimester were enrolled using purposive sampling. Blood pressure readings were categorized as normotensive (≤139 mmHg) or hypertensive (≥140 mmHg). rBPP scores were obtained via ultrasound, with a total score of 4 considered normal, 2 partially abnormal, and 0 totally abnormal. Data were analyzed using SPSS to generate descriptive statistics.

Results: Out of 74 participants, 50 (67.57%) were hypertensive. Normal rBPP scores (4/4) were observed in 62.16% of cases, while 24.32% showed partial abnormality and 13.51% total abnormality. All cases of totally abnormal rBPP scores occurred in the hypertensive group. A higher incidence of abnormal rBPP scores was also associated with increasing maternal age, particularly between 31 and 40 years.

Conclusion: Maternal hypertension is associated with a measurable decline in fetal rBPP scores, underscoring the impact of elevated blood pressure on fetal well-being. rBPP provides a practical, time-efficient method for fetal monitoring in hypertensive pregnancies and should be integrated into routine antenatal surveillance protocols in similar clinical settings.

Key Words: Rapid Biophysical Profile; Hypertensive Pregnancy; Fetal Surveillance; Third Trimester High-Risk Pregnancy Monitoring.