Biophysical profile

Overview

• A fetal biophysical profile is a prenatal test used to check

on a baby's well-being. The test combines fetal heart rate
monitoring (nonstress test) and fetal ultrasound to
evaluate a baby's heart rate, breathing, movements,
muscle tone and amniotic fluid level. The nonstress test
and ultrasound measurements are then each given a
score based on whether certain criteria are met.
• Typically, a biophysical profile is recommended for women
at increased risk of problems that could lead to
complications or pregnancy loss. The test is usually done
after week 32 of pregnancy, but can be done when your
pregnancy is far enough along for delivery to be
considered — usually after week 24. A low score on a
biophysical profile might indicate that you and your baby
need further testing. In some cases, early or immediate
delivery might be recommended.
• A biophysical profile is a noninvasive test that doesn't
pose any physical risks to you or your baby. However, it's
not always clear that the test improves pregnancy
outcomes. Find out what a biophysical profile involves
and whether this prenatal test might benefit your baby.
 Why it's done

• A biophysical profile is used to evaluate and monitor a

baby's health. The goal of a biophysical profile is to
prevent pregnancy loss and detect a low oxygen supply in
the baby (fetal hypoxia) early enough so that the baby can
be delivered and not sustain permanent damage.
• The test is most commonly done when there's an
increased risk of problems that could lead to
complications or pregnancy loss. Your health care
provider will determine the necessity and timing of a
biophysical profile based on whether your baby could
survive if delivered early, the severity of your condition
and the risk of pregnancy loss.
• Your health care provider might initially recommend a
modified biophysical profile — a simplified version of the
test that includes a nonstress test and assesses amniotic
fluid through ultrasound. He or she will use the results to
determine whether you need a full biophysical profile,
which also measures a baby's breathing, movements and
muscle tone, or other tests.
• Your health care provider might recommend a biophysical
profile if:
 You have a multiple pregnancy with certain complications
 You have a medical condition, such as diabetes, high blood
pressure, lupus or heart disease
 Your pregnancy has extended two weeks past your due date
(postterm pregnancy)
 You have a history of pregnancy loss or previous pregnancy
complications
 Your baby has decreased fetal movements or possible fetal
growth problems
You have too much amniotic fluid (polyhydramnios) or a
low amniotic fluid volume (oligohydramnios)
You have rhesus (Rh) sensitization — a potentially
serious condition that can occur when your blood group is
Rh negative and your baby's blood group is Rh positive
You are older than age 35
You are obese
• Your health care provider might also recommend a
biophysical profile if you're between 40 and 42 weeks
pregnant. The benefits of having the test done during this
period, however, aren't clear.
• Your health care provider might recommend that you have
a biophysical profile once a week or twice a week,
depending on your health condition — until you deliver.
 Risks

• A biophysical profile is a noninvasive test that poses no

physical risks to you or your baby.
• While a biophysical profile can offer reassurance about
your baby's health, it can also cause anxiety. In addition, a
biophysical profile might not detect an existing problem or
might suggest that a problem exists when there is none. A
test that falsely indicates a problem might cause your
health care provider to recommend unnecessary tests or
early delivery.
• Also, keep in mind that it's not always clear that the test
can improve pregnancy outcomes.
 How you prepare

• A biophysical profile typically requires no special

preparation.
 What you can expect

• A biophysical profile can be done in your health care

provider's office or in a hospital. The test might take 30
minutes or so to complete. A modified biophysical profile
takes less time.
 During the procedure

• During the nonstress test, you'll lie on an exam table and

have a belt placed across your abdomen. The belt
contains a sensor that measures the fetal heart rate. The
heart rate is recorded by a machine. If your baby is
asleep, you might need to wait until he or she awakens to
ensure accurate results. In some cases, your health care
provider might try to awaken the baby by projecting a
sound over your abdomen.
• During the ultrasound exam, you'll also lie on an exam
table. Your health care provider or an ultrasound
technician will apply a small amount of gel to your
abdomen. Then he or she will roll a small device called a
transducer over your skin. The transducer will emit pulses
of sound waves that will be translated into a pattern of
light and dark areas — creating an image of your baby on
a monitor.
• Your health care provider or the ultrasound technician will
then evaluate your baby's breathing movements, body
movements, muscle tone and amniotic fluid level. If your
baby is asleep, this portion of the test might take a little
longer.
 After the procedure

• When the biophysical profile is complete, your health care

provider will likely discuss the results with you right away.
 Results

• Each area that's evaluated during a biophysical profile is

given a score of 0 or 2 points, depending on whether
specific criteria were met. A score can be given
immediately. For example:
• Fetal heart rate monitoring. Results of this portion of the
test (nonstress test) are interpreted as reactive or
nonreactive. If your baby's heartbeat accelerates twice or
more a certain amount within a 20-minute period, the
results are considered reactive and 2 points will be given.
If not enough accelerations occur within a 40-minute
period, the results are considered nonreactive and 0
points will be given. Keep in mind that nonreactive results
might occur because your baby was asleep during the
test.
• Fetal breathing. If your baby displays at least one
episode of rhythmic breathing for 30 seconds or more
within 30 minutes, 2 points will be given. If your baby's
breathing doesn't meet the criteria, 0 points will be given.
• Fetal movement. If your baby moves his or her body or
limbs three times or more within 30 minutes, 2 points will
be given. If your baby's movements don't meet the
criteria, 0 points will be given.
• Fetal muscle tone. If your baby moves a limb from a bent
position to an extended position and quickly back to a
bent position, 2 points will be given. If your baby's muscle
tone doesn't meet the criteria, 0 points will be given.
• Amniotic fluid level. The ultrasound technician will look
for the largest visible pocket of amniotic fluid. To obtain a
score of 2 points, the pocket must be a certain size. If
your amniotic fluid level doesn't meet the criteria, 0 points
will be given.
• The individual scores are then added together for a total
score. Typically, a score of 8 to 10 is reassuring. If you
receive a score of 6, your health care provider will likely
repeat the test within 24 hours or, if your pregnancy is
near term, delivery might be recommended. A score of 4
or lower means that further testing is needed or that you
might need to deliver the baby early or immediately.
• In addition, if your health care provider finds that you have
a low amount of amniotic fluid, you'll need further testing
and might need to deliver your baby early — regardless of
your overall score.
• Certain factors can affect the results of a biophysical
profile, including the recent use of corticosteroids to
speed your baby's lung maturity. Taking certain
medications, such as morphine, also can affect the score.

• Be sure to discuss the results of your biophysical profile

with your health care provider to fully understand what
they might mean for you and your baby.