My daughter is 25 weeks pregnant, CMV-positive, and her provider suggests that as long as the biophysical profile is well, she does not need to worry about the fetus. Could you please, explain what does a biophysical profile mean? Thank you.
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CMV during pregnancy and biophysical profile
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Featured Answer
1 UpVoted this answer
I'll try to be concise. Biophysical profile (BP) is based on the real-time untrasonography results. It provides with numerical parameters about the fetal well-being. One of the advantages of this test is its high sensitivity (lower false positive results). BP is performed after the non-stress test, for 30 minutes and is scored between 0 and 10.
Score 8-10 - normal test
Score 6-7 - indicates on chronic asphyxia and requires retest in 24 hours.
Score < 6 - indicates that the pregnancy needs to be terminated as the conditions for the fetus are unfavorable.
With any score <8, oligohydramnious should be considered as an indication for delivery unless PROM is present (premature rupture of amniotic sac).
The test parameters are these:
FETAL BREATHING MOVEMENTS - abnormal when less than 30 sec of movements in 30 minutes
FETAL MOVEMENTS - abnormal when 2 or less body movements in 30 min of observation
FETAL TONE - abnormal, when fetus is in a position of semi or full-limb extension with no return to flexion with movement; absence of fetal movement is counted as absent tone.
FETAL REACTIVITY- abnormal when no acceleration or less than two accelerations of the fetal heart rate are observed in 40 minutes
AMNIOTIC FLUID VOLUME - abnormal when the largest pocket of amniotic fluid measures < 1 cm in two perpendicular planes.
If the provider suggest that your daughter's BP is fine, s/he means that the BP scores in the region of 8-10, therefore no abnormalities are observed.
As for the CMV, it is crucial to appreciate when your daughter became infected for the first time: during or before the pregnancy? The IgG antibody to CMV indicates past maternal infection. Recurrent maternal infection is possible, as CMV remains dormant after initial infection. Fortunately, the risk of passing the virus from mother to baby during the recurrent infection is very low (1%) and the risk of serious complications is even lower. Make sure your daughter is regularly checked for IgM to CMV. If it is positive, the provider will advise which type of medicine to take to protect the fetus. Good luck!
Score 8-10 - normal test
Score 6-7 - indicates on chronic asphyxia and requires retest in 24 hours.
Score < 6 - indicates that the pregnancy needs to be terminated as the conditions for the fetus are unfavorable.
With any score <8, oligohydramnious should be considered as an indication for delivery unless PROM is present (premature rupture of amniotic sac).
The test parameters are these:
FETAL BREATHING MOVEMENTS - abnormal when less than 30 sec of movements in 30 minutes
FETAL MOVEMENTS - abnormal when 2 or less body movements in 30 min of observation
FETAL TONE - abnormal, when fetus is in a position of semi or full-limb extension with no return to flexion with movement; absence of fetal movement is counted as absent tone.
FETAL REACTIVITY- abnormal when no acceleration or less than two accelerations of the fetal heart rate are observed in 40 minutes
AMNIOTIC FLUID VOLUME - abnormal when the largest pocket of amniotic fluid measures < 1 cm in two perpendicular planes.
If the provider suggest that your daughter's BP is fine, s/he means that the BP scores in the region of 8-10, therefore no abnormalities are observed.
As for the CMV, it is crucial to appreciate when your daughter became infected for the first time: during or before the pregnancy? The IgG antibody to CMV indicates past maternal infection. Recurrent maternal infection is possible, as CMV remains dormant after initial infection. Fortunately, the risk of passing the virus from mother to baby during the recurrent infection is very low (1%) and the risk of serious complications is even lower. Make sure your daughter is regularly checked for IgM to CMV. If it is positive, the provider will advise which type of medicine to take to protect the fetus. Good luck!
A biophysical profile aka BPP includes 4 findings, each worth 2 points, on an ultrasound determined to indicate fetal well being. These 4 items include amniotic fluid, fetal movement, fetal tone and fetal breathing. A BPP can also include a non stress test aka NST, which is monitoring the baby's heart rate until 2 accelerations in heart beat are noted and no decelerations. This is also worth 2 points. A score of 8 or 10 is reassuring.
The first question I have is what does "CMV -positive mean"? If your daughter has a positive IgM test I am not sure I would agree that a good score on a BPP (biophysical profile) indicates the fetus is well. However if your daughter has a positive IgG test then that means she was infected with CMV previously and the risk to the fetus is extremely low. I would recommend she see a Maternal Fetal Medicine (high risk OB) who can answer these questions. Fetal infection with CMV can be devastating, and as a parent would want to be prepared if that is the case. Good luck.
This is a test that have five
components. It tests fetal
well-being.Two scores are
assessed for each of the
five components. 10/10 is
the highest. It's somewhat
similar to the Apgar score
which is given after the
baby is born.
components. It tests fetal
well-being.Two scores are
assessed for each of the
five components. 10/10 is
the highest. It's somewhat
similar to the Apgar score
which is given after the
baby is born.
I am not sure what he meant. It is a sign of ineptness or inadequacy on behalf of a physician who does not explain to the client or patient exactly what he means. There is no reason for it. It may also be that he or she is not sure but if that is the case then he or she should make that clear instead of acting as if he or she knows everything.