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  1. #1
    Join Date
    Apr 2013

    Post dates, biophysicals, and inductions

    Hi everyone,

    I'm currently 40 weeks + 4 days, and have a biophysical and EFW scan tomorrow morning. I'm assuming the EFW will be fine, but as I've measured consistently at 35 weeks for the past 5 weeks, and lost 3 lbs this past week, we're doing it to be sure. If the baby's growth has slowed significantly, I'm likely going to opt for induction.

    I don't know what to expect from a biophysical. I know how it's scored and what point induction is recommended, but I'm not really sure if this could be an unnecessary induction. I'm just curious about people's personal experiences with going post-dates and the decisions they made, what they tried before induction, how the induction went, and if anyone has any good resources talking about making medical decisions based on a biophysical.
    Lillian Elizabeth 6.16.13

  2. #3
    Join Date
    Sep 2012
    Los Angeles
    The biophysical profile is a very good assessment as to how your baby is doing. EFW is variable and there isn't much to hang your hat on, but the BPP looks at your amniotic fluid, the baby's big movements and small movements, baby's heart rate, and the baby's respirations. You're often told to drink something sugary and high energy beforehand to make sure baby is maximally awake and jiving. You get two points for each of those five markers, for a max score of 10. (And it's 0 or 2, no 1).

    If your score is 8 or 10, that's considered reassuring and induction is not discussed unless something else comes up (usually if your amniotic fluid volume has dropped too low).

    If your score is 2 or 0, you are always emergently induced as the baby is dead or near dead.

    If your score is 4, you are induced if you're at least 32 weeks pregnant, as this indicates serious compromise to the baby.

    If your score is 6, it's tougher. You're usually induced if you're at least 36 weeks AND if your cervix is favorable, but there is some debate about expectant management.

    Unfortunately, as to whether or not a potential induction is unnecessary- that's an unanswerable question. The only way you'd know for sure if *any* intervention or treatment is unnecessary is if you could conduct a simultaneous experiment where you both opt for and opt against the treatment, and then compare outcomes. Since we all only get to do these things one time, you'll never know.

    I have shared this data many times on nameberry, but the in utero death rate starts to climb in the 41st week (it nearly doubles the rate of the 40th week). Still, the rate is around the level of the 35-36th week so routine induction is not performed until the 42nd week, when the rates really skyrocket to unacceptable levels (nearly 3-4x as high as the 40th week). I personally opted for induction at 41 weeks exactly due to this data.
    Blade, MD

    XY: Antoine Raphael; Julian Victor
    XX: Cassia Viviane Noor

    Allaire * Emmanuelle * Honora * Lysandra * Marina * Rosamond * Serena * Sylvie * Thea * Verity / Blaise * Cyprian * Evander * Jules * Laurence * Lucian * Marius * Quentin * Rainier * Silvan

    Hayat _ Qamar _ Sahar _ / Altair _ Faraj _ Tariq

  3. #5
    Join Date
    Apr 2013
    Thank you, Blade, I was hoping you'd chime in.

    My bpp was excellent, fluid was good, and EFW was 7 lbs 11 oz, which I know is inaccurate but as long as it was bigger than the last one, we were good.

    I go for another one on monday (41+1) and have a doctor's visit tuesday where induction will be discussed. I don't know if I'd opt for an induction earlier in the week or wait until closer to 42 weeks if I'm perfectly healthy and the sonos are showing that everything's still good.
    Lillian Elizabeth 6.16.13

  4. #7
    Join Date
    Feb 2012
    Glad your tests were good! I hope you go into labor soon, then you won't have to make this decision :-)
    Wife to Jordan.
    Mommy to Everett Callan, born 2010 and Callie Sage Eilonwy, born 2013
    and 2 fur babies: a male standard poodle named Shasta, and a female Australian shepherd named Scout.

    If you have any questions about PCOS, infertility, ectopic pregnancy, or Cystic Fibrosis testing, please feel free to message me

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