A randomized clinical trial of daily nonstress testing versus biophysical profile in the management of preterm premature rupture of membranes

David F. Lewis, Charles Adair, Jonathan W. Weeks, P. Scott Barrilleaux, Michael S. Edwards, Thomas J. Garite

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

OBJECTIVE: Our purpose was to evaluate the ability of 2 different antepartum testing modalities to predict infectious morbidity in patients with preterm premature rupture of membranes. STUDY DESIGN: During a 36-month period, patients with preterm premature rupture of membranes (at 23 to 34 weeks of gestation) were randomly assigned to either a daily nonstress test or a biophysical profile, after a 24-hour observational period. We used the original scoring system of Manning et al for the biophysical profile, with a score of ≤6 considered abnormal. Nonstress test results were considered abnormal if the test was non reactive or if the patient had late decelerations or significant variable decelerations; abnormal results led to further evaluation with a biophysical profile. Results of the last test before delivery were evaluated to determine whether infectious complications had been predicted. RESULTS: One hundred thirty-five patients were enrolled in the study. Demographics, pregnancy characteristics, and neonatal outcomes were similar. Neither the daily nonstress test nor the daily biophysical profile had good sensitivity for predicting infectious complications (39.1% and 25.0%, respectively). However, both had good specificity (84.6% and 92.6%, respectively). Positive and negative predictive values were 52.9% and 75.9%, respectively, for the daily nonstress test and 66.7% and 68.4%, respectively, for the daily biophysical profile. Cost was significantly higher in the daily biophysical profile group. Nonstress testing of patients at <28 weeks' gestation generally required a backup biophysical profile. CONCLUSION: Neither the daily nonstress test nor the daily biophysical profile had good sensitivity for predicting infectious complications after preterm premature rupture of membranes.

Original languageEnglish (US)
Pages (from-to)1495-1499
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume181
Issue number6
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

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Randomized Controlled Trials
Deceleration
Pregnancy
Demography
Preterm Premature Rupture of the Membranes
Morbidity
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

A randomized clinical trial of daily nonstress testing versus biophysical profile in the management of preterm premature rupture of membranes. / Lewis, David F.; Adair, Charles; Weeks, Jonathan W.; Barrilleaux, P. Scott; Edwards, Michael S.; Garite, Thomas J.

In: American Journal of Obstetrics and Gynecology, Vol. 181, No. 6, 01.01.1999, p. 1495-1499.

Research output: Contribution to journalArticle

Lewis, David F. ; Adair, Charles ; Weeks, Jonathan W. ; Barrilleaux, P. Scott ; Edwards, Michael S. ; Garite, Thomas J. / A randomized clinical trial of daily nonstress testing versus biophysical profile in the management of preterm premature rupture of membranes. In: American Journal of Obstetrics and Gynecology. 1999 ; Vol. 181, No. 6. pp. 1495-1499.
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