Definition A biophysical profile (BPP) is a way to check the status of a developing baby, or fetus. A BPP includes an ultrasound, which is a type of x-ray test that uses sound waves. A BPP also includes checking the baby's heart rate for a period of time. This part of the test is also called a nonstress test. A BPP is usually done in the last three months, or third trimester, of pregnancy.
Who is a candidate for the test? Doctors may order a BPP whenever they are concerned about the health of the baby. Examples of conditions that may require BPP testing include:
history of miscarriage or stillbirth, which is the delivery of a baby that is dead
woman older than age 35 in some cases
multiple pregnancy, such as twins or triplets
a baby that is developing too slowly
too little or too much amniotic fluid, the fluid surrounding the baby
a pregnancy that lasts longer than 41 to 42 weeks
drug addiction in the mother
recent car accident or other trauma
decreased movements of the baby as felt by the mother
early rupture of the membranes that surround and protect the baby in the womb
How is the test performed? During the procedure, the mother lies on her left side to maximize blood flow to the baby. The doctor usually does a nonstress test first. This involves putting stickers on the skin of the mother's belly. The baby's heart tracing is then recorded through the skin painlessly. This is followed by a detailed ultrasound. The BPP results in a score of zero to 10. Each part of the profile may receive a score of zero or two. The higher the score, the better. The scoring is as follows:
nonstress test. The baby gets a score of two if the heart rate is normal over time. If the heart is not normal, the baby gets a score of zero.
fetal breathing movements. The baby gets a score of two if he or she has normal breathing activity. A score of zero is given for an absence of normal breathing activity.
fetal body movements. A score of two is given for normal, active body movements. A score of zero means absent or decreased movements.
fetal tone. The baby gets a score of two if its arms and legs are flexed with one episode of stretching or extending the limbs. A score of zero means the baby didn't move or doesn't have normal flexed arm and leg position.
amniotic fluid volume. A baby receives a score of two if there is a normal amount of amniotic fluid. Too little amniotic fluid gives a score of zero.
What is involved in preparation for the test? A woman does not need to prepare for the test.
What do the test results mean? A score of 8 to 10 is considered normal. A score of 6 is borderline. A score below 6 means that the baby may have problems if labor begins. Abnormal results may require repeat of the BPP or even immediate delivery. Low scores in biophysical profiles may mean the following:
the baby is not getting enough oxygen
too much acid is in the baby's body fluids
the baby is very ill or even dying
Further, more aggressive testing or even immediate delivery may be needed if the BPP is below normal.
Author: Eva Martin, MD Reviewer: Adam Brochert, MD Last Updated: 05/10/00 Contributors Potential conflict of interest information for reviewers available on request
