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:
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.
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
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Frequently Asked Questions
How is fetal well-being assessed?
Fetal well-being is assessed through the biophysical profile test during pregnancy. This involves examining the baby's heart rate, movements, muscle tone, breathing patterns, and amniotic fluid levels to ensure proper oxygen supply and development. This test helps detect potential issues and ensures a safe delivery if concerns arise.
What detects fetal breathing movements?
Fetal ultrasound is used to detect fetal breathing movements during a biophysical profile. This non-invasive technique allows for visualizing the baby's chest wall movement, indicating fetal respiration activity within the womb. This assessment is one of the key components evaluated to estimate perinatal outcomes during pregnancy.
Who interprets test results?
Interpreting test results from a biophysical profile is typically done by the healthcare provider who conducted the test, such as a Maternal-Fetal Medicine specialist like Dr. Steve Rad. This expert analyzes the baby's heart rate, movements, muscle tone, breathing, and amniotic fluid to assess well-being within the womb.
What indicates fetal hypoxia?
A biophysical profile score of less than eight indicates fetal hypoxia, suggesting inadequate oxygen supply, requiring further medical evaluation to ensure the baby's well-being and proper intervention if necessary. This score is crucial in identifying potential issues with the baby's oxygen levels during pregnancy.
What anticipates preterm labor?
Preterm labor can be expected due to factors like infections, high blood pressure, multiple pregnancies, preterm birth in a prior pregnancy, cervical insufficiency, uterine abnormalities, or lifestyle choices such as smoking or drug use. Regular prenatal care and monitoring are essential to mitigate these risks.
Can tests guide delivery timing?
Tests like the biophysical profile can guide delivery timing by assessing the baby's well-being. Low scores may indicate a need for early delivery to prevent potential complications. These tests provide valuable insights for healthcare providers to make informed decisions about the safest delivery timing for the health of both the baby and the mother.
How does testing influence management?
Testing influences management by providing crucial information about a pregnant individual's and baby's health, allowing for early detection and intervention in cases of potential complications, ensuring a safe delivery and positive perinatal outcomes. The results guide healthcare providers in determining appropriate medical responses and further monitoring or interventions as needed.
Can tests alter delivery methods?
Tests like the biophysical profile can help determine if a baby is receiving enough oxygen for a safe delivery. Depending on the results, the doctor may recommend a specific delivery method, ensuring the best possible outcome for both the mother and baby.
What suggests fetal compromise?
A biophysical profile score of less than eight suggests fetal compromise, indicating potential oxygen insufficiency requiring further evaluation. Factors including prematurity and maternal corticosteroid use can influence scores, necessitating careful assessment for appropriate interventions.
How reliable is scoring?
Scoring in a biophysical profile is reliable for estimating perinatal outcomes by assessing multiple fetal parameters. A score of less than eight may indicate inadequate oxygen, prompting further evaluation. Understanding factors influencing scores ensures accurate assessments and appropriate medical responses.
What examines fetal tone?
The biophysical profile assesses fetal muscle tone as one of its components to estimate perinatal outcomes during pregnancy. This test evaluates several parameters, including fetal heart rate, body movements, breathing movements, and amniotic fluid volume, providing a comprehensive view of the baby's well-being in the womb.
Can tests assess fetal activity?
Yes, tests like the biophysical profile assess fetal activity through components like heart rate, body movements, muscle tone, breathing, and amniotic fluid levels. These tests help evaluate the overall well-being of the baby during pregnancy, especially for high-risk individuals or those with specific concerns.
Are tests safe post-due date?
Post-due date tests like the biophysical profile are generally safe. They help monitor the baby's well-being to ensure a safe delivery without lasting damage. The reliability of such tests is crucial for high-risk pregnancies to address any potential issues promptly.
Can tests reduce stillbirth risk?
Biophysical profile tests can help detect potential issues like low oxygen, abnormalities in amniotic fluid, or fetal movements, reducing stillbirth risks by enabling early interventions and monitoring. Regular monitoring through tests may lower the chances of stillbirth by identifying problems promptly.
Can tests warrant immediate delivery?
Biophysical profile tests can prompt immediate delivery if the results indicate a baby may not be receiving enough oxygen, signifying potential distress. Further evaluation is needed to decide on timely intervention for the safety of the baby and mother.
How soon are results available?
Results of the biophysical profile test are typically available immediately after completion of the assessment.
What reflects adequate oxygenation?
A biophysical profile score of less than eight indicates potential inadequate oxygenation, necessitating further evaluation for appropriate medical response and interventions. Additional considerations include factors like fetal prematurity and maternal corticosteroid use, impacting the accuracy of the baby's condition assessment during the test.
Can testing prevent complications?
The biophysical profile test can help prevent complications by identifying potential issues early. It's particularly beneficial for high-risk pregnancies, individuals with certain conditions, or concerns like decreased fetal movements or abnormal amniotic fluid levels. Testing is instrumental in ensuring safe deliveries and healthy outcomes for both mother and baby.
What guides umbilical cord assessment?
The biophysical profile evaluates perinatal outcomes through the baby's heart rate, movements, muscle tone, breathing, and amniotic fluid levels. It helps detect potential issues early, making it crucial for high-risk pregnancies. Dr. Steve Rad, a maternal-fetal medicine expert in Los Angeles, provides comprehensive care for such cases.
How does monitoring aid diagnosis?
Monitoring aids diagnosis by assessing heart rate, movements, muscle tone, breathing, and fluid levels to detect issues early in pregnancy, allowing for prompt intervention to ensure a safe delivery and healthy baby.
Can testing improve neonatal outcomes?
Testing, like the biophysical profile during pregnancy, can enhance neonatal outcomes by identifying potential issues early, such as low oxygen supply, to enable timely interventions and safe delivery without lasting damage.
What predicts fetal acidemia risk?
Fetal acidemia risk can be predicted based on the results of a biophysical profile test. Abnormal scores, particularly below eight, may suggest insufficient oxygen supply to the baby, indicating the possibility of fetal acidemia and the need for further evaluation and potential interventions to ensure the baby's health and safety.
What assesses fetal reflexes?
The biophysical profile is recommended during pregnancy to assess fetal reflexes by looking at heart rate, body movements, muscle tone, breathing movements, and amniotic fluid volume. This test helps to estimate perinatal outcomes by evaluating the baby's overall health and well-being.
Are false positives a concern?
False positives are not a significant concern with the biophysical profile test. The test is valuable for assessing perinatal outcomes and guiding appropriate medical interventions when needed.
Can tests impact labor decisions?
Tests like the biophysical profile can influence labor decisions by providing crucial information on the baby's well-being. A low score may indicate the need for immediate intervention, guiding obstetricians in making decisions regarding the timing or method of delivery to ensure the safest outcome for both mother and baby.
How is non-reactivity addressed?
Non-reactivity during a biophysical profile may be addressed by stimulating fetal movement prior to the test through intake of a meal. This approach can increase the baby's activity, aiding in a more accurate evaluation of the five components measured in the biophysical profile.
What follows an abnormal score?
An abnormal biophysical profile score may lead to further evaluation to determine the baby's oxygen supply. It's crucial to consider factors like prematurity and medications affecting fetal activity to decide on appropriate medical interventions or monitoring. Understanding these nuances guides effective management decisions.
How does the protocol differ?
The biophysical profile assesses multiple parameters to estimate perinatal outcomes during pregnancy, whereas the modified version may involve alternate antepartum fetal surveillance if oxygen levels and amniotic fluid are within range. Both aim to ensure the baby's health and well-being.
Can evaluations suggest growth issues?
Evaluations such as the biophysical profile during pregnancy can indicate growth issues in the baby, allowing for early detection and appropriate intervention if necessary. This test assesses various aspects of the baby's development, including size, movements, and amniotic fluid levels, which can signal potential growth concerns.
Are follow-up tests routine?
Follow-up tests may be recommended based on the results of the biophysical profile to ensure continued monitoring and assessment of the baby's well-being throughout the pregnancy. Depending on the specific circumstances and any identified concerns, additional tests or interventions may be advised to maintain a safe and healthy pregnancy.
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