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Fetal Biophysical Profile (BPP) Score
Antepartum assessment of fetal wellbeing combining ultrasound observation with the non-stress test.
Fetal Biophysical Profile (BPP) Score
Fetal breathing movements
Normal: at least one episode of rhythmic fetal breathing lasting at least 30 seconds within a 30-minute observation period.
Gross body movements
Normal: at least 3 discrete body or limb movements within 30 minutes (episodes of continuous movement count as a single movement).
Fetal tone
Normal: at least one episode of active extension of a limb or the trunk with return to flexion, or opening and closing of a hand.
Fetal heart rate reactivity (non-stress test)
Normal: at least 2 accelerations of >=15 bpm above baseline, each lasting >=15 seconds, associated with fetal movement, within a 20-minute window.
Amniotic fluid volume
Normal: a single deepest vertical pocket of amniotic fluid greater than 2 cm.
Result10 / 10 points
Normal biophysical profile. Risk of chronic fetal asphyxia is low; repeat testing per routine antepartum surveillance interval.
- Total score
- 10 / 10
When to use
- Antepartum surveillance of fetuses at increased risk of hypoxia/asphyxia (e.g. post-dates pregnancy, suspected growth restriction, maternal diabetes or hypertension, decreased fetal movement).
- Adjunct to the non-stress test to reduce false-positive abnormal testing and guide timing of delivery.
Formula
Five components — fetal breathing movements, gross body movements, fetal tone, fetal heart rate reactivity (NST), and amniotic fluid volume — are each scored 2 (normal) or 0 (abnormal) using strict criteria observed over a defined period. Total score = sum of the five components, range 0-10 (even numbers only).
Pearls and pitfalls
- Oligohydramnios (single deepest vertical pocket <=2 cm) warrants further evaluation even when the total score is reassuring, as it may reflect uteroplacental insufficiency.
- A 'modified BPP' (NST + amniotic fluid index only) is commonly used as a faster screening alternative; the full 5-component profile described here is the original Manning score.