The results of a prospective clinical management based on a fetal biophysical profile scoring method were evaluated in 1184 referred high-risk patients. Six perinatal deaths occurred in the study group (perinatal mortality of 5.06/1000); only 1 fetus suffered unpredictable and unpreventable death (true false negative rate 0.8/1000). Thirteen fetuses with major congenital anomalies were detected as a result of ultrasound scanning for fetal biophysical activities. Apparently this method can be used effectively to screen and manage a high-risk population.