A biophysical profile (BPP) is a non-invasive prenatal test performed during pregnancy to assess a baby’s overall health. It combines an ultrasound examination and a non-stress test (NST). A BPP helps healthcare providers determine if the baby is receiving enough oxygen and nutrients, and identifies potential concerns.
Components of the Biophysical Profile
A biophysical profile evaluates five parameters. Four are observed using ultrasound, and the fifth is assessed through a non-stress test. Each component is assigned a score.
Fetal breathing movements are observed via ultrasound, watching for practice breathing motions. Their presence indicates neurological maturity and healthy lung development.
Gross body movements are the baby’s larger movements, such as stretching or turning. Sufficient movements suggest a healthy central nervous system and adequate oxygenation. Fetal tone assesses the baby’s muscle flexion and extension. Good muscle tone indicates neurological integrity and sufficient oxygen supply.
Amniotic fluid volume measures the fluid surrounding the baby in the uterus. This fluid is crucial for fetal growth, movement, and lung development, reflecting kidney function and hydration. Providers measure fluid pockets to determine adequacy.
The non-stress test (NST) monitors the baby’s heart rate in response to movement. Sensors on the mother’s abdomen track the baby’s heart rate and uterine contractions. A healthy baby shows heart rate accelerations when moving, indicating a reactive nervous system.
Reasons for a Biophysical Profile
Healthcare providers recommend a biophysical profile for various reasons, often when there are concerns about the baby’s well-being or when the pregnancy is considered high-risk. Common indications include maternal health conditions such as diabetes, high blood pressure, or pre-eclampsia, which can affect placental function.
A BPP may also be ordered if the mother reports decreased fetal movement, or for post-term pregnancies to ensure the placenta continues to function adequately. Other reasons include fetal growth concerns, a history of complications in previous pregnancies such as a stillbirth, multiple pregnancies, or suspected placental issues.
Interpreting Your BPP Score
The results of a biophysical profile are presented as a score. Each of the five components assessed (four ultrasound parameters and the non-stress test) is assigned 0 or 2 points. These individual scores are then added together to yield a total score, usually out of a maximum of 10 points.
A total score of 8 to 10 points is generally considered reassuring, indicating the baby is in good health and well-oxygenated. This score suggests that the baby’s nervous system and other vital functions are working as expected.
A score of 6 points is often considered equivocal or borderline. This may prompt a repeat BPP within 12 to 24 hours to re-evaluate the baby’s condition, or it might lead to closer monitoring.
A score of 4 points or less is concerning and often indicates a potential problem with the baby’s well-being. Such a low score may necessitate immediate action or further diagnostic evaluations to determine the cause of distress. The interpretation of the BPP score is always done in conjunction with the overall clinical picture by a healthcare provider.
Next Steps After a Biophysical Profile
Once a biophysical profile is completed and the score is determined, the healthcare provider will discuss the results and outline the appropriate next steps. If the BPP score is reassuring, typically 8 to 10 points, no immediate further action may be required, and the pregnancy can proceed as usual. The provider might recommend continuing routine prenatal care or repeating the BPP at a later date if clinically indicated.
For equivocal scores, such as 6 points, the healthcare team might recommend a repeat biophysical profile within a short timeframe, often within 12 to 24 hours, to reassess the baby’s condition. This allows for observation of any changes and helps determine if the initial score was an anomaly or indicative of a developing issue.
In cases of concerning scores, typically 4 points or less, more immediate interventions may be necessary. This could include closer and more frequent monitoring of the baby, or in some situations, the healthcare provider may recommend induction of labor or a C-section to facilitate an earlier delivery. All decisions regarding next steps are made based on the specific BPP results, the gestational age, the mother’s medical history, and the overall clinical assessment, always in consultation with the healthcare provider.