What is a fetal biophysical profile?
The fetal biophysical profile (BPP) is a test given to high-risk pregnant women during the third trimester of pregnancy (after 28 weeks gestation). This antepartum fetal evaluation combines the test results of a non-stress test (NST) and a fetal ultrasound to generate a biophysical profile score. Results outside of normal are not cause for emergency or worry. If the score is not high enough, the doctor will likely rerun the test within 24 hours.
Why might a biophysical profile be recommended during pregnancy?
The biophysical profile is recommended during pregnancy to estimate perinatal outcomes by assessing the baby’s heart rate, body movements, muscle tone, breathing movements, and amniotic fluid volume. This test is particularly important for high-risk pregnant women, as it helps to uncover potential issues early on, such as low oxygen supply in the baby, to facilitate a safe delivery without lasting damage.
The test may be suggested for pregnant individuals who are overweight, over the age of 35, carrying multiple pregnancies with complications, have chronic conditions like diabetes or high blood pressure, or are past their due date.
Additional specific conditions and scenarios where a biophysical profile might be recommended include severe cases of asthma, kidney disease, or if you are pregnant with more than one baby. It is also advised if there has been a stillbirth in a prior pregnancy, if the baby appears smaller than expected at a particular stage of your pregnancy, if the baby’s movements have slowed down or stopped, or if there are abnormalities in the amount of amniotic fluid, either too much or too little.
In cases where there is a history of pregnancy loss, decreased fetal movements, abnormal amniotic fluid levels, or blood type incompatibility between the mother and baby, a biophysical profile may also be recommended.
Understanding the intricacies of this test begins with your high-risk pregnancy specialist. Patients in the Los Angeles area seek the expert counsel of Dr. Steve Rad, a double-board certified Obstetrician-Gynecologist with sub-specialty training in Maternal-Fetal Medicine (MFM).
How do you prepare for a biophysical profile?
Preparing for a biophysical profile (BPP) is straightforward as the procedure is noninvasive and generally requires no special preparation. It’s often recommended to have a meal before undergoing the test because it can help increase the baby’s activity, which is beneficial for the assessment. Additionally, for your comfort during the BPP, it’s advisable to use the restroom and empty your bladder before the session starts.
The biophysical profile test
Doctors use the BPP to avoid pregnancy loss and uncover a low oxygen supply in the baby early enough to have a safe delivery without sustaining any permanent damage.
Your doctor may suggest a biophysical profile if you are:
- Overweight
- Over the age of 35
- Carrying multiple pregnancies (twins, triplets, etc.) with specific complications
- Suffering from a chronic condition such as diabetes, high blood pressure, preeclampsia, lupus, or heart disease
- Past your due date
A biophysical profile may also be recommended if:
- The mother has a history of pregnancy loss or birthing complications.
- The baby’s movements have decreased or not grown.
- The amniotic fluid index is too much (polyhydramnios) or too little (oligohydramnios).
- The mother’s blood type is negative, while the baby’s is positive.
What is a non-stress test in pregnancy?
This safe, non-invasive test is performed using sensors wrapped around the pregnant patient’s belly. The test includes fetal heart rate monitoring as well as a contraction test.
What is ultrasound for pregnancy?
The ultrasound evaluation that is part of the biophysical profile is just like any other ultrasounds you may have during pregnancy. A technician moves the ultrasound machine over the belly to observe the uterus and the well-being of the fetus.
Ultrasounds are used during all pregnancies to monitor fetal growth.
Biophysical profile score
The biophysical score is how doctors make sense of the procedure’s results. There are five components in the test — each one worth two points; a 10 would, therefore, be a perfect score.
Biophysical score components
Fetal breathing movements
- Normal (2 points) – One or more episodes of fetal breathing lasting at least 30 seconds within 30 minutes.
- Abnormal (0 points) – No fetal breathing movements lasting at least 30 seconds in 30 minutes.
Gross body movement
- Normal (2 points) – Three or more body or limb accelerations within 30 minutes.
- Abnormal (0 points) – Less than three body movements in 30 minutes.
Fetal tone
- Normal (2 points) – One or more episodes of active extension or opening and closing of the hand.
- Abnormal (0 points) – Slow extension and flexion of extremity or no fetal movement.
Amniotic fluid
- Normal (2 points) – Should have more than 2 centimeters of fluid.
- Abnormal (0 points) – Fluid volume is less than 2 centimeters.
Non-stress test
- Normal (2 points) – A reactive non-stress result indicates that blood flow (and oxygen) to the fetus is adequate.
- Abnormal (0 points) – Fetus not getting sufficient blood and oxygen. More testing is required.
Biophysical profile test score results
The biophysical profile estimates perinatal outcomes by looking at five areas of development: the baby’s heart rate, body movements, muscle tone, breathing movements, and amniotic fluid volume. A total score of at least eight is considered normal, indicating that the baby is likely receiving sufficient oxygen and showing expected levels of activity. However, a score of less than eight indicates that the baby may not be getting sufficient oxygen, which necessitates further evaluation to determine the appropriate medical response.
If the biophysical profile score is four or less, delivery is induced because there is a risk of stillbirth or fetal asphyxia. It is critical to recognize that biophysical profile scores can also be influenced by factors such as fetal prematurity and the mother’s use of corticosteroids, which can reduce fetal activity. Understanding these nuances helps in accurately assessing the baby’s condition and deciding on further medical or monitoring interventions.”<
Modified biophysical profile
Often, if the baby is getting sufficient oxygen and the amniotic fluid volume is within the acceptable range, alternate antepartum fetal surveillance can be performed. The doctor will perform a modified biophysical profile; this test consists of a non-stress test and a measure of amniotic fluid.
The modified biophysical profile (MPP) may be performed because of decreased fetal movement. If the NST is nonreactive or the amniotic fluid volume is low a full biophysical profile is usually done.
More about Dr. Rad
Perinatologist Dr. Rad and his world-class Maternal-Fetal Medicine (MFM) obstetrics and gynecology team at Los Angeles Fetal and Maternal Care understand your High-Risk OB and infertility needs before, during, and after birth. We provide compassionate care and help you understand your pregnancy, answer questions, and provide emotional support to safely navigate your pregnancy.
Dr. Rad advises expectant mothers to remain vigilant about their conditions. Low-risk pregnancies can quickly escalate to fetal health emergencies and perinatal mortality. The team is also available to provide expert second opinions concerning potential defects in the fetus.
Dr. Rad has undergone rigorous pediatric training with high honors at prestigious renowned institutions- David Geffen School of Medicine at UCLA, USC, Cedars-Sinai Medical Center, UCSF Medical Center as well as centers internationally including in London, Austria, Israel, and Africa.
Call us at (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.
If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide.
Call (844) 473-6100 or click here to schedule online
