Biophysical profile (BPP) is a scoring system which measures the health and well being of the fetus. The scoring system is used in high risk pregnancies such as mothers who do drugs while being pregnant, and with decreased fetal movement, or when there is nonreactive nonstress test.
2 points are given to each perimeter which consists the BPP:
- Nonstress test
- Fetal tone (fetus flexes or extends an extremity)
- Fetal movement (at least 2 or more in 30 minutes)
- Fetal breathing (chest expansion must be 1 or more in 30 minutes or breathing of 20 seconds in 30 minutes)
- Amniotic fluid index (measure with sonogram)
If each perimeters exist then a score of 2 is given, if not then a score of 0 is given. A BPP of 8-10 is normal, 4-8 is inconclusive, and a score of 4 or below is abnormal. A biophysical profile score of 2 or less is fetal asphyxia (deprived of oxygen) and the fetus must be delivered immediately.
Other minor points to consider:
- When there is BPP score of 8 and there is decrease of amniotic fluid (oligohydramnios) , delivery should be considered since complications will likely happen.
- If the patient is less than 37 weeks gestation the BPP should be repeated in 24 hours. If it doesn’t improve in 24 hours than then delivery should be done.
- When the BPP score is 6 without oligohydramnios, delivery should be considered if the patient is greater than 37 weeks gestation.
- When the BPP score is 6 with oligohydramnios then delivery should be done if above 32 weeks gestation.
- When the BPP score is 6 and the patient is less than 32 weeks gestation then daily monitoring should be done.
- When the BPP score is 4 and the patient is greater than 26 weeks gestation, then delivery should be done.