A biophysical profile (BPP) is a way to check the status of an unborn child as he or she develops in the womb.
Who is a candidate for the test?
The healthcare professional may order a BPP if there is concern about the health of the baby.
A BPP may be ordered if the mother has one or more of the following health problems:
- autoimmune disorder, which is a condition in which the body creates antibodies against its own tissues for no known reason
- certain kidney, lung, or heart diseases
- chronic high blood pressure
- drug addiction
- history of miscarriage or stillbirth
- HIV or AIDS
- preeclampsia, a type of high blood pressure that can occur during pregnancy
- recent car accident or other trauma
- sickle cell anemia, which results in abnormal red blood cells
A BPP may also be done if the healthcare professional suspects problems with the pregnancy, such as:
- certain problems with the placenta, which attaches the baby to the mother
- early rupture of the membranes that surround and protect the baby in the womb
- a pregnancy that lasts longer than 41 to 42 weeks
- Rh incompatibility between mother and baby
- too little or too much amniotic fluid, the fluid surrounding the baby
A BPP may also be ordered because of problems in the developing infant, including:
- a baby that is developing too slowly
- decreased movements of the baby as felt by the mother
- an infant with known birth defects
- multiple pregnancy, such as twins or triplets
How is the test performed?
During the procedure, the mother lies on her left side to maximize blood flow to the baby. The healthcare professional usually does a nonstress test first. This involves pasting electrodes on the skin of the mother's abdomen. The baby's heart tracing is then recorded through the skin painlessly. This is followed by a detailed pregnancy ultrasound.
The BPP results in a score of zero to 10. Each part of the profile may receive a score of zero or 2. Unlike with the APGAR score used for evaluating newborns, the items on the BPP cannot receive an intermediate score of "1". The higher the score, the better.
The scoring is as follows:
- amniotic fluid volume. A baby receives a score of 2 if there is a normal amount of amniotic fluid. Too little amniotic fluid results in a score of zero.
- fetal body movements. A score of 2 is given for normal, active body movements. A score of zero means absent or decreased movements.
- fetal breathing movements. The baby gets a score of 2 if he or she has normal breathing activity. A score of zero is given for an absence of normal breathing activity.
- fetal tone. The baby gets a score of 2 if his or her arms and legs are flexed with one episode of stretching or extending the limbs. A score of zero means the baby does not move, or does not show normal flexed arm and leg positions.
- nonstress test. The baby gets a score of 2 if the heart rate is normal over time. If the heart is not normal, the baby gets a score of zero.
What is involved in preparation for the test?
There is no preparation needed for a biophysical profile.
What do the test results mean?
A score of 8 to 10 is considered normal.
A score of 6 is borderline and calls for the test to be repeated in 12 to 24 hours.
A score below 6 means that the baby may have problems if labor begins. The low score could indicate that:
- the baby's body fluids may contain too much acid
- the baby may not be getting enough oxygen.
- the baby may be very ill or even dying.
In this case, an immediate repeat BPP, further, more aggressive testing, or even immediate delivery, possibly by C-section, may be needed.