Biophysical Profile (BPP) : Test, Preparations, Results and Risk Factors

What is a Biophysical Profile?

The biophysical profile, or BPP, is a prenatal test to monitor your baby’s health. It is a combination of non-invasive diagnostic tests usually performed after the 28th week of pregnancy. The test doesn’t cause any physical harm to you or your baby. The objective is to support women with high-risk pregnancies and prevent potential harm to the baby for a successful delivery.

Why is a Biophysical Profile Performed?

The BPP test is performed to prevent pregnancy loss and enable early detection of low oxygen supply to the baby to prevent permanent damage. The test is mainly recommended for women whose pregnancies are considered high-risk and could cause severe complications or miscarriage.

The doctor might also recommend a BPP test for certain conditions to check its impact on the baby, such as:

• You are past your due date.
• You’re at an increased risk of health conditions like high blood pressure, diabetes, or heart disease.
• You have had a fall.
• You have a record of pregnancy complications or pregnancy loss.
• Your baby has shown decreased movements.
• You have extremely high or a low amniotic fluid volume.
• You have multiple pregnancies  (twins, triplets).
• You are above 35 years of age.
• You are obese.

What are the Risk Factors Associated with the Biophysical Profile Test?

A BPP test is performed to offer reassurance about your baby’s health. It usually poses no physical risk to you or your baby. Although it is a non-invasive test, it can lead to anxiety or stress. Also, a BPP might not detect an existing problem or indicate a false problem, leading to unnecessary test recommendations or early delivery.

Also, keep in mind that it’s not always clear that the test can improve pregnancy outcomes.

A BPP result may be affected if a pregnant woman is treated with corticosteroids to speed the baby’s lung maturity, as it can lead to reduced fetal breathing rate and movement for a few days. In some cases, the test may need to be done again for clearer results.

How do you Prepare for a Biophysical Profile Test?

A BPP test is an outpatient test of short duration  and doesn’t require any special preparations. The test is performed in a clinic or hospital and takes about 30 minutes, after which you can go home.

What to Expect from the Biophysical Profile Test?

BPP test is a combination of an ultrasound examination with a nonstress test.

1. Ultrasound Examination: During an ultrasound examination, you’ll have to lie on your back. The doctor or technician will then place a transducer against your belly to generate sound waves that echo from within the body. These echoes are visible and are  monitored on a screen. The ultrasound examination monitors the baby’s movement, muscle tone, breathing, and the amount of amniotic fluid protecting your baby in the womb. The ultrasound gets done within 30 minutes.
2. Non stress test: During the non stress examination also, you’ll lie on an exam table. The non stress test measures and records the speed of your baby’s heartbeat during movement. The doctor will attach an elastic band with two sensors around your abdomen to track your baby’s heartbeat. A buzzer is used, or sound is projected over the abdomen to awaken the baby and stimulate movement. A non stress check is done within 20 minutes.

What are the Possible Results of the Test?

The results of the BPP test are generated immediately after the test. Each area that’s evaluated is given a score of 0 or 2 points, depending on whether specific criteria were met. Any component that does not satisfy the criteria receives a zero. Each score is added to get a total score.

The criteria for evaluating and scoring are:

• Heart Rate Monitoring: If your baby’s heartbeat accelerates at least twice within 20 minutes, the results are interpreted as reactive, and 2 points are allocated. The results are considered nonreactive if movement does not increase your baby’s heartbeat within a 40-minute duration. In this case, 0 points are allocated.
• Breathing Movement: If your baby displays one or more episodes of rhythmic breathing lasting at least 30 seconds within a 30-minute duration, it will be scored as 2 points. If no episodes are recorded during the set duration, 0 points will be given.
• Body Movement:  2 points will be scored  if your baby moves at least three times or more within 30 minutes. If there is no movement, 0 points will be given.
• Muscle Tone: 2 points are allocated if your baby can stretch and extend its arm or leg from a bent position within 30 minutes. It is measured by counting quick, jerky movements of the limbs. If your baby doesn’t change position within this time frame, 0 points will be given.
• Amniotic fluid level: During the ultrasound, the doctor or technician will examine the largest visible pocket of amniotic fluid. If the pocket measures at least one centimeter across and two centimeters vertically, 2 points will be given. 0 points are allocated if the fluid volume doesn’t meet the set measures.

Generally, a score of 8 to 10 points is considered normal. The doctor may recommend retest within the next 24 hours if the score is between 6 and 8. A score of 4 points or lower may indicate problems related to pregnancy. The doctor may conduct further testing to examine the baby’s health or recommend early or immediate delivery.

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Conclusion:

BPP is a noninvasive and short test, unlike the several other tests you’ll likely have during pregnancy. The test helps determine your baby’s well-being. Discuss the results of your biophysical profile with your doctor to understand what they might mean for you and your baby.

Frequently Asked Questions (FAQs)

Are there any other tests similar to the biophysical profile?

A few tests are similar to the BPP test, such as prenatal abdominal ultrasound scan, amniotic fluid index (AFI), deep pocket measurement, a nonstress test (alone), and amniotic fluid volume assessment.

How often is the biophysical test done during pregnancy?

Generally, the BPP test is done in the last trimester or after the 28th week of pregnancy. However, if the doctor observes any pregnancy-related risks, he may advise getting the BPP test done earlier. Some of the risks include preeclampsia, diabetes, asthma, hypertension, renal disorders, or any major problems that may lead to pregnancy loss. In such cases, the doctor may also recommend follow-up BPP tests until delivery.

Is a biophysical profile painful?

No, BPP is not painful as it is a noninvasive test of short duration. However, you might feel anxious about getting a test. Lying on your back during the test may be uncomfortable. You might also feel a slight pressure in your bladder during the ultrasound when the transducer is passed over the abdomen.