A biophysical profile (BPP) is a prenatal ultrasound evaluation of fetal well-being involving a scoring system, with the score being termed Manning's score. 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.
The BPP has 5 components: 4 ultrasound (US) assessments and a NST. The NST evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables:
- 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 in 30 minutes||None or less than 30s or 20s|
|US: Fetal activity / gross body movements||At least three or two movements of the torso or limbs||Less than three or two movements|
|US: Fetal muscle tone||At least one episode of active bending and straightening of the limb or trunk||No movements or movements slow and incomplete|
|US: Qualitative AFV/AFI||At least one vertical pocket> 2 cm or more in the vertical axis||Largest vertical pocket</=2 cm|
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 breathing movements do not occur in the first half.
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.
- Alfirevic Z, Neilson JP (2000). Alfirevic, Zarko, ed. "Biophysical profile for fetal assessment in high risk pregnancies". Cochrane Database Syst Rev (2): CD000038. doi:10.1002/14651858.CD000038. PMID 10796097.
- 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
- "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.
- 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.