| Biophysical profile | |
|---|---|
 | |
| Synonyms | BPP |
| Purpose | prenatal evaluation ultrasound |
A biophysical profile (BPP) is a prenatal ultrasound evaluation of fetal well-being involving a scoring system, [1] with the score being termed Manning's score. [2] It is often done when a non-stress test (NST) is non reactive, or for other obstetrical indications.
The "modified biophysical profile" consists of the NST and amniotic fluid index only.
Procedure
The BPP has five components: four ultrasound (US) assessments and an NST. The NST evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables are:
- Fetal heart rate
- Fetal breathing
- Fetal movement
- Fetal tone
- Amniotic fluid volume
| Parameter | Normal (2 points) | Abnormal (0 points) |
|---|---|---|
| NST/Reactive FHR | At least two accelerations in 20 minutes | Less than two accelerations to satisfy the test in 20 minutes |
| US: Fetal breathing movements | At least one episode of > 30s or >20s [3] in 30 minutes | None or less than 30s or 20s [3] |
| US: Fetal activity / gross body movements | At least three discrete body/limb movement in 30 minutes (episodes of active continuous movement considered a single movement. | Less than three or two [3] movements |
| US: Fetal muscle tone | At least one [3] episode of active extension with return to flexion of fetal limb(s) or trunk, opening and closing of hand considered to be normal tone. | Either slow extension with return to partial flexion or movement of limb in full extension or absent fetal movement. |
| US: Qualitative AFV/ AFI | At least one vertical pocket > 2 cm in the vertical axis or AFI of 5 cm | Largest vertical pocket </= 2 cm, or AFI </= 5 cm |
Use of vibroacoustic stimulation to accelerate evaluation has been described. [4]
Interpretation
Each assessment is graded either 0 or 2 points and then added up to yield a number between 0 and 10. A BPP of 8 or 10 is generally considered reassuring. A BPP normally is not performed before the second half of a pregnancy since fetal movements do not occur in the first half. [5] The presence of these biophysical variables implies absence of significant central nervous system hypoxemia/acidemia at the time of testing. By comparison, a compromised fetus typically exhibits loss of accelerations of the fetal heart rate (FHR), decreased body movement and breathing, hypotonia, and, less acutely, decreased amniotic fluid volume.
| BPP | Recommended management |
|---|---|
| ≤2 | |
| 4 |
|
| 6 |
|
| ≥ 8 |
|
See also
References
- ^ Lalor JG, Fawole B, Alfirevic Z, Devane D (2008-01-23). "Biophysical profile for fetal assessment in high risk pregnancies". The Cochrane Database of Systematic Reviews. 2008 (1): CD000038. doi: 10.1002/14651858.CD000038.pub2. ISSN 1469-493X. PMC 7052779. PMID 18253968.
- ^ Page 215, Chapter 39 on Biophysical Profile (BPP), in: Title: Diagnostic Ultrasound, Volume: 2, Issue: 1 of The Veterinary clinics of North America. Equine practice, Author: Norman W. Rantanen. Publisher: Jaypee Brothers Publishers, 1986. ISBN 9788184480641. Length: 261 pages
- ^ a b c d "Biophysical Profile, Ultrasound: eMedicine Radiology". Retrieved 2009-12-29.
- ^ Pinette MG, Blackstone J, Wax JR, Cartin A (June 2005). "Using fetal acoustic stimulation to shorten the biophysical profile". J Clin Ultrasound. 33 (5): 223–5. doi: 10.1002/jcu.20116. PMID 16047387. S2CID 32503466.
- ^ Mari E (2018-04-17). "Decreased Fetal Movements are an Important Red Flag in Second Half of Pregnancy: A Case Report of Baby Saved by Mother's Attention to Fetal Movements". Current Opinion in Gynecology and Obstetrics. 1 (1): 21–27. doi: 10.18314/cogo.v1i1.862. ISSN 2637-4617. S2CID 59490398.
-
^ Intrauterine Growth Retardation. ROBERT C. VANDENBOSCHE, M.D., and JEFFREY T. KIRCHNER, D.O., Lancaster General Hospital, Lancaster, Pennsylvania. Am Fam Physician. 1998 Oct 15;58(6):1384-1390.
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