الفهرس 
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Abstract
Role of modified biophysical profile and Doppler velocimetry of umbilical artery in prediction of perinatal outcome in prolonged pregnancy. Study type: Prospective clinical. Study setting: Department of Obstetrics & Gynecology, Faculty of Medicine, Benha University, Benha, Egypt. Study duration: May 2016 to June 2017. Introduction: Post-term pregnancies are associated with numerous adverse outcomes. In addition to mortality, there is an increased risk of meconium aspiration syndrome, neonatal seizure and long term handicap (Maryam et al., 2009). Options for evaluating fetal wellbeing among post-term patients include non-stress test, biophysical profile (BPP) or modified BPP (non-stress test plus amniotic fluid volume estimation), and a combination of these modalities (Cunningham et al., 2014). Umbilical artery angle-independent indices (pulsatility index or systolic/diastolic (S/D) ratio) decrease with advancing gestation because of a decreased placental vascular resistance, which occurs physiologically with advancing gestation (Mari G et al., 2008). Aim of the study: To determine the value of the modified biophysical profile and umbilical artery Doppler indices (pulsatility index, resistance index and systolic/diastolic (S/D) ratio) in predicting pregnancy outcome at or beyond 41 weeks of gestation.Patients:
300 Egyptian pregnant women postdate Methods:
All patients were submitted to * Thorough history taking
* Complete general examination including calculation of BMI.
Procedures: * Doppler on umbilical artery * NST * AFI calculation by ultrasound Statically:
Based on the gestational age and the relation of it to the presence or absence of adverse perinatal outcome, the study population was divided into two groups as follows: 1st group: group of women who delivered at or beyond 40 weeks and less than 41 weeks i.e. (280 to 286) day gestation. 2nd group: group of women who delivered at or beyond 41 weeks i.e. (287 to 294) day gestation. Then the results were tabulated & statistically analyzed where A probability value (p value) more than 0.05 was considered to be not significant , P value less than 0.05 was considered to be statistically significant & p value less than 0.001 was considered to be statistically highly significant. Results: Prominent changes in AFI (i.e. <50% increase or decrease) is not associated with adverse perinatal outcome irrespective of the rate of change provided that the final value remains >5.0 cm. A significant association with FHR decelerations and presence of meconium is proved to exist when AFI is <5.0 cm. Non-reassuring CTG in postdate should managed be carefully to avoid adverse perinatal changes especially if associated with oligohydramnios or Doppler changes. Umbilical artery Doppler indices (UA-PI, UA-RI), so it is a good test to reassure the obstetricians of the fetal wellbeing. Based on the results of this study, AFI seemed to have been with higher sensitivity and specificity to predict adverse perinatal effect in postdates.