fetal biophysical profile
Fetal biophysical profile score (BPS or BPP) refers to assessment of four discrete biophysical variables by ultrasound. It is a standard tool in antepartum fetal assessment. It is usually assessed after 28 weeks of gestation.
Radiographic features
Antenatal ultrasound
The ultrasound variables are:
- fetal breathing: considered abnormal if there is
- absent breathing
- no breathing episode for ≥20 seconds within a 30 minute lapse
- fetal tone: considered abnormal if there is
- slow extension with return to partial flexion
- absent fetal movement
- fetal movement (gross body movement): considered abnormal if there is
- <2 episodes of body/limb movements within a 30 minute lapse
- amniotic fluid volume: considered abnormal if the largest pocket is <2 x 2 cm
Each of these parameters is given a score of either 0 or 2 points, where an abnormal score gets 0 while a normal score gets 2.
Therefore on ultrasound assessment, a total score is given out of 8. An overall abnormal score out of 8 is often taken as 4/8 or less.
In addition to this, an additional non sonographic variable (non-stress test) with two extra points can also be taken into account. In which case a score is given out of 10.
Potential confounding variables
Some reports show maternal fasting resulting in reduced fetal breathing movements which can in turn affect the BPP score .
Additional work up
Umbilical arterial Doppler assessment is usually additionally carried out to evaluate fetuses with abnormal BPP scores.
History and etymology
The score was initially proposed by F A Manning et al. in 1980 .
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