Biophysical Profiles

A. What it is

A biophysical profile (BPP) measures the health of your little one during your pregnancy. It is typically performed after your 32nd week of pregnancy to evaluate little one's health. it is often done when your pregnancy is considered high risk due to health conditions or you have had irregular test results and helps answer any questions your health care provider may have about your little one's well being. The BPP checks your little one's heart rate, muscle tone, movement, and breathing. It also measures the amount of amniotic fluid around your little one. Looking at these five areas helps your doctor know how well your little one is doing. this test is non invasive and low risk, much like your ultrasound scans. this can take no longer than 30 to 40 mins.

B. How it is done

The BPP has two parts. First you have a non-stress test, then you have a fetal ultrasound. For the tests, you will lie on a padded examination table. If you become short of breath or light-headed while lying on your back, say so. The technician can help you change your position.

Non-stress test

Two elastic belts with sensors are placed across your belly much like when you give birth. One sensor tracks your little one's heart rate with reflected sound waves (Doppler ultrasound). The other measures how long your contractions are, IF you are having any.

You may hear your little one's heartbeat as a beeping sound. You may see it printed out on a chart.

You may be asked to push a button on the machine when your little one moves or you have a contraction. This helps your doctor look at how your little one's heart reacts to movement and contractions.

If there isn't much movement, it may be because your little one is probably asleep.. If this happens during your test, the technician may try to wake your little one with a loud noise or by having you eat or drink something.

Fetal ultrasound

A gel will be spread on your belly. This helps the passage of sound waves.

A small, hand-held sensor will be pressed against the gel on your skin and moved across your belly a few times.

You may be able to watch the screen to see the picture of your little one during the test.

C. What it measures

The BPP has a scoring system to rate the little one in 4 different areas:

⦁ Body movement: the little one moves it's limbs or body

⦁ Muscle tone: the little one opens and closes their hands or bends and extends their arms or legs

⦁ Breathing movements: the little one has continuious rythmic breathing

⦁ Amniotic fluid volume: there is a pocket of fluid that measures at least 1cm across and 2 cm vertically, in other words, there is enough for your little one to be suspended in

D. What do the results mean

Each of the four components receives either zero or two points. You can’t get one point. The maximum you can score is eight points. The higher your score, the better health the little one is assumed to be in.

The criteria to earn two points for each component are:

⦁ Fetal gross body movement: Three or more separate movements of the fetus’s body or limbs in 30 minutes.

⦁ Fetal muscle tone: One or more episodes of active extension and flexion of an arm or leg, or the opening and closing of a hand, in 30 minutes.

⦁ Fetal breathing movements: At least one episode of continuous breathing that lasts at least 30 seconds during the 30-minute test.

⦁ Amniotic fluid volume: At least one pocket of amniotic fluid that measures 1 centimeter across and 2 centimeters vertically.

Any component that doesn’t meet the criteria above is considered irregular and receives a score of zero points.

Don’t panic though if the results of your biophysical profile are abnormal. It doesn’t mean there’s a problem. Certain conditions and factors could affect your score. This is when your provider may order a nonstress test. In a nonstress test, there need to be at least two episodes of heart rate acceleration in 20 minutes. This means when the little one moves, their heartbeat should increase, similar to how your heartbeat increases when you walk up the stairs. If two accelerations occur, you get an additional two points.

E. How the results may influence the onset of labor

⦁ A score of 8-10: Is reassuring and represents a normal well oxegenated little one and no need for intervention, continued weekly testing can be recommended.no action needed, deliver at term.

⦁ A score of 4-6: May require a second BPP within 24 hours, more immediate further testing, depending on how far you are in your pregnancy, your little one may be delivered. If at 6 repeat test or deliver if at term, if at 4, delivery is usually discussed depending on your situation.

⦁ A score of 0 or 2: Would almost always lead to immediate delivery, but being that your are most of the way through your pregnancy, your little one will have a good chance outside the womb with specialized care.