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High-risk pregnancy and the biophysical profile

The biophysical profile, or BPP, is a test that checks foetal health in high-risk pregnancies. The BPP combines foetal heart rate monitoring (non-stress test), with an ultrasound examination, and it's usually done after the 28th week of pregnancy.

The test checks foetal movements, tone, breathing and amniotic fluid volume.

Depending on the BPP test results, other tests may be arranged, or plans made for caesarean section delivery instead of vaginal birth.

The BPP takes 20 to 60 minutes, and like the foetal heart rate monitoring (non-stress test), can be done on an outpatient basis.

Each parameter, plus the non-stress test, gets a score from 0 to 2. The scores are then added up for a combined maximum of 10. The interpretation of the BPP score depends on the clinical situation. In general, a score of 8 or 10 is considered normal, while a score below 8 usually requires further evaluation or delivery of the baby.

What a Biophysical Profile Shows
Normal (Score=2)Abnormal (Score=0)

Foetal heart rate

(Non-stress test)

Foetal tone1 or more extensions of arm/leg or trunk with return to flexion; opening and closing of handNo or slow movements
Foetal breathing movements1 or more period of rhythmic breathing lasting at least 30 seconds within a 30-minute intervalNo period of rhythmic breathing within 30 minutes
Gross body movements3 or more discrete body/limb movements in 30 minutesLess than 3 in 30 minutes
Amniotic fluid volumeAt least one pocket of amniotic fluid 2 cm or moreNo amniotic fluid pockets

The indications for both the non-stress test and the BPP are similar, and your doctor will decide which test is appropriate for your situation.

Reasons to do a biophysical profile

  • Overdue pregnancy
  • Maternal medical conditions such as high blood pressure, diabetes, and heart or kidney disease
  • Multiple gestation (twins, triplets)
  • Decreased amniotic fluid (oligohydramnios)
  • Small baby (intrauterine growth restriction)
  • Placental abnormality
  • Previous unexplained foetal death
  • Maternal perception of decreased foetal movement
  • Premature rupture of foetal membranes
  • Other signs of foetal distress
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on November 03, 2016

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