The modified biophysical profile: antepartum testing in the 1990s

Article Abstract:

The modified biophysical profile prenatal test may have an acceptable false-negative rate, while the false-positive rate may lead to preterm delivery of a small number of infants. Researchers evaluated the results of 54,617 modified biophysical profiles performed on 15,482 high-risk pregnant women. The false-positive rate was 60%, and may have caused the premature delivery of 1.5% of women tested before term. The false-negative rate was found to be an acceptable 0.8%. Both false rates compare well with those of other prenatal tests. Use of the modified biophysical profile may have reduced the stillbirth rate among high-risk women by 6.75 times as compared to untested, lower risk women. The modified biophysical profile may take less time to perform and require less experience with ultrasound.

Analysis, Fetus, Medical examination, Prenatal diagnosis, False positive reactions

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Cesarean birth: how to reduce the rate

Article Abstract:

The U.S. cesarean section rate may be reduced if obstetricians perform fewer first-time cesarean sections and fewer sections in cases of difficult birth. The U.S. cesarean section rate has been as high as 25%, and recently the rate has declined slightly. The rate increased since the 1960s because it became safe, it reduced maternal complications and deaths, and it increased the survival rate of preterm infants. A national goal proposed by the government is to lower the cesarean rate to 15% by the year 2000. This goal is unattainable, since the rate of cesareans among first-time mothers is too high allow the overall cesarean rate to be reduced so fast. Increasing the vaginal birth after cesarean section (VBAC) rate by allowing trials of labor may reduce the overall rate even further.

Prevention, Cesarean section

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Vaginal birth after cesarean section in twin gestation

Article Abstract:

Trial of labor in a twin pregnancy after a prior cesarean appears to be a superior option to scheduled repeat cesarean for many women. Researchers compared outcomes among women carrying twins after a prior cesarean section of whom 92 had a trial of labor and 210 had a planned cesarean. Seventy percent of the laboring group gave birth vaginally. No laboring woman experienced scar-related problems. Seventeen percent of the laboring group experienced complications compared with 39% of the planned cesarean group.

Management, Vaginal birth after cesarean, Multiple birth

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