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 5

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 3.

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Article information

rID: 12785
System: Obstetrics
Section: Gamuts
Synonyms or Alternate Spellings:
  • BPP
  • BPS
  • Fetal biophysical profile (BPP)
  • Fetal biophysical profile score (BPS)
  • Biophysical profile score
  • Biophysical profile
  • Fetal BPP

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