From the Guidelines
A biophysical profile (BPP) ultrasound is a comprehensive assessment of fetal well-being that consists of four ultrasound-based components: fetal breathing movements, discrete body movements, fetal tone, and amniotic fluid volume, with each component receiving a score of 0 or 2, leading to a maximum score of 8 1.
Key Components of BPP
- Fetal breathing movements: at least one episode continuing for 30 seconds within the 30-minute BPP
- Discrete body movements: at least three discrete body or limb movements during the examination
- Fetal tone: one or more episodes of active extensions and return to flexion
- Amniotic fluid volume: at least one 2 cm pocket present ### Scoring and Interpretation The BPP score is calculated by assigning 2 points for each of the four components that meet the defined criteria, resulting in a maximum score of 8. If the non-stress test (NST) is included, it is assigned a score of 2 if reactive, for a combined score out of 10. A composite score of 8 or 10 is considered normal, 6 is equivocal, and 4 or less is abnormal 1.
Clinical Application
The BPP is an essential tool for assessing fetal well-being, particularly in high-risk pregnancies, and is often used in conjunction with other tests, such as the NST and Doppler velocimetry, to evaluate fetal health and guide clinical decision-making 2, 3, 4, 5.
From the Research
Definition and Components of Biophysical Profile (BPP) Ultrasound
- The biophysical profile (BPP) ultrasound is a non-invasive test used to assess fetal well-being, particularly in high-risk pregnancies 6, 7.
- The BPP evaluates five components: + Fetal heart rate + Fetal breathing movements + Fetal body movements + Fetal tone + Amniotic fluid volume 8, 9, 10
Purpose and Interpretation of BPP Ultrasound
- The primary purpose of the BPP ultrasound is to estimate the risk of hypoxia and perinatal morbidity and mortality in fetuses 6.
- The test results are used to identify fetuses that may be at risk and require closer monitoring or intervention 7, 10.
- The BPP score is calculated based on the presence or absence of each component, with a maximum score of 10 8, 9.
Clinical Applications and Limitations of BPP Ultrasound
- The BPP ultrasound has been shown to be a useful tool in assessing fetal well-being, particularly in high-risk pregnancies 6, 7.
- However, the test has limitations, and its predictive value may be influenced by various factors, such as fetal gestational age and maternal health status 8, 9, 10.
- The BPP ultrasound should be used in conjunction with other fetal assessment methods, such as non-stress tests and Doppler flowmetry, to provide a comprehensive evaluation of fetal well-being 6, 7.